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NPI Code Detail

MEDICARE: ALAN STUART PC

MEDICARE: ALAN STUART PC
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
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1578301875
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALAN STUART PC
Provider Business Mailing Address
First Line : 425 NE 12TH ST
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-2823
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2450 COLORADO AVE STE 100E
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-5535
Country : US
Telephone Number : 323-205-5737
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ALAN STUART
Credential : PA
Telephone Number : 323-205-5737
Provider Enumeration Date : 07/19/2024
Last Update Date : 07/19/2024

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