MEDICARE: DR ALAN GROSSMAN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPC1087	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487794764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR ALAN GROSSMAN PA

Provider Business Mailing Address
First Line	:	18557 WEST DIXIE HIGHWAY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33180
Country	:	US
Telephone Number	:	305-466-0777
Fax Number	:	305-466-0773

Provider Business Practice Location Address
First Line	:	18557 WEST DIXIE HIGHWAY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33180
Country	:	US
Telephone Number	:	305-466-0777
Fax Number	:	305-466-0773

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. ALAN S GROSSMAN
Credential	:	O.D.
Telephone Number	:	305-466-0777

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	02/10/2009

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Directions to “DR ALAN GROSSMAN PA ” Practice Location

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