Healthcare Provider Details

I. General information

NPI: 1790765626
Provider Name (Legal Business Name): ALAN BARTON HALSEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3658 LITHIA PINECREST RD
VALRICO FL
33596-6305
US

IV. Provider business mailing address

3658 LITHIA PINECREST RD
VALRICO FL
33596-6305
US

V. Phone/Fax

Practice location:
  • Phone: 813-681-6537
  • Fax: 813-661-3227
Mailing address:
  • Phone: 813-681-6537
  • Fax: 813-661-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberME0043624
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: