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General NPI Number Information
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NPI Number | 1891973145
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Entity Type | Organization
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Legal Business Name | ALAN D SIROTA DPM PA
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 2911 RED BUG LAKE RD STE 300
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City | CASSELBERRY
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State | FL
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Zip | 32707-5916
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Country | US
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Telephone | 407-695-7075
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Fax | 407-695-2069
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Provider Business Mailing Address
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Address Line | 2911 RED BUG LAKE RD STE 300
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City | CASSELBERRY
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State | FL
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Zip | 32707-5916
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Country | US
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Telephone | 407-695-7075
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Fax | 407-695-2069
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ALAN DALE SIROTA
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Credential | DPM
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Telephone | 407-695-7075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO1395
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License Number State | FL
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