MEDICARE: ALAN L TANNENBAUM MD PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	111N00000X	Chiropractor
2	207R00000X	Internal Medicine Physician
3	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38626	OTHER	FL	BS

General Provider Information

NPI Number	:	1902885270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAN L TANNENBAUM MD PA

Provider Business Mailing Address
First Line	:	523 CAPE CORAL PKWY E
Second Line	:	PRIMARY CARE ASSOC
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8545
Country	:	US
Telephone Number	:	239-549-2772
Fax Number	:	239-549-2332

Provider Business Practice Location Address
First Line	:	523 CAPE CORAL PKWY E
Second Line	:	PRIMARY CARE ASSOC
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-8545
Country	:	US
Telephone Number	:	239-549-2772
Fax Number	:	239-549-2332

Authorized Official
Title or Position	:	OWNER/PRIMARY OFFICER
Name	:	ALAN L TANNENBAUM
Credential	:	MD
Telephone Number	:	239-549-2772

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	09/11/2025

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Directions to “ALAN L TANNENBAUM MD PA ” Practice Location

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