Healthcare Provider Details

I. General information

NPI: 1487640256
Provider Name (Legal Business Name): ALLAN GITTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N FEDERAL HWY
POMPANO BEACH FL
33064-6741
US

IV. Provider business mailing address

3333 N FEDERAL HWY
POMPANO BEACH FL
33064-6741
US

V. Phone/Fax

Practice location:
  • Phone: 954-941-8866
  • Fax: 954-941-9950
Mailing address:
  • Phone: 954-941-8866
  • Fax: 954-941-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME0051209
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: