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1831395987

NPI Code Detail

MEDICARE: DR. ALAN EDWIN SIROY M.D., M.P.H.

MEDICARE: DR. ALAN EDWIN SIROY M.D., M.P.H.

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	207ZM0300X	Medical Microbiology Physician	55785	MN
2	207ZM0300X	Medical Microbiology Physician	106209	MN
3	207ZD0900X	Dermatopathology (Pathology) Physician	ME132575	FL
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	57.014310	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	JA168A	OTHER	FL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831395987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN EDWIN SIROY M.D., M.P.H.

Provider Business Mailing Address
First Line	:	2725 SW 121ST WAY
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-0142
Country	:	US
Telephone Number	:	618-203-6584
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-1197
Country	:	US
Telephone Number	:	352-548-6607
Fax Number	:

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

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	11/27/2023

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Directions to “ DR. ALAN EDWIN SIROY M.D., M.P.H.” Practice Location

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