MEDICARE: DR. ALAN M WEINTRAUB MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	ME59366	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11969	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0004389	OTHER	FL	UNITED
4	110178341	OTHER	FL	RAILROAD

General Provider Information

NPI Number	:	1780609065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN M WEINTRAUB MD

Provider Business Mailing Address
First Line	:	3001 EXECUTIVE DR STE 130
Second Line	:
City	:	CLEARWATER
State	:	FL
Zip	:	33762-5323
Country	:	US
Telephone Number	:	727-347-0005
Fax Number	:	275-416-5587

Provider Business Practice Location Address
First Line	:	4108 HENDERSON BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-5750
Country	:	US
Telephone Number	:	813-289-4321
Fax Number	:	813-247-2949

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	05/12/2021

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