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General NPI Number Information
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NPI Number | 1679757918
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Entity Type | Organization
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Legal Business Name | DR ALAN H SIEGEL P A
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Dates
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Enumeration Date | 12/21/2007
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 10692 S US HIGHWAY 1 SUITE B
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6408
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Country | US
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Telephone | 772-335-5006
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Fax | 772-335-4672
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Provider Business Mailing Address
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Address Line | 10692 S US HIGHWAY 1 SUITE B
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-6408
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Country | US
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Telephone | 772-335-5006
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Fax | 772-335-4672
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ALAN HOWARD SIEGEL
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Credential | O.D.
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Telephone | 772-335-5006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | FL1190
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC1190
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License Number State | FL
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