Healthcare Provider Details

I. General information

NPI: 1417061656
Provider Name (Legal Business Name): ALAN R SINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17511 N DALE MABRY HWY
LUTZ FL
33548-4521
US

IV. Provider business mailing address

PO BOX 22606
TAMPA FL
33622-2606
US

V. Phone/Fax

Practice location:
  • Phone: 813-962-6700
  • Fax: 813-962-7799
Mailing address:
  • Phone: 813-962-6700
  • Fax: 813-962-7799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME92666
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: