Provider Demographics
NPI:1518026475
Name:NETZMAN, ALAN A (DO, PA)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:A
Last Name:NETZMAN
Suffix:
Gender:M
Credentials:DO, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5701 OVERSEAS HWY
Mailing Address - Street 2:SUITE 8
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-2784
Mailing Address - Country:US
Mailing Address - Phone:305-743-3511
Mailing Address - Fax:305-743-2765
Practice Address - Street 1:5701 OVERSEAS HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-2784
Practice Address - Country:US
Practice Address - Phone:305-743-3511
Practice Address - Fax:305-743-2765
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4620208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1598927386OtherNPI ORGANIZATIONAL
FL82785OtherBLUE CROSS BLUE SHIELD
FL040023800Medicaid
FL82785AMedicare PIN
FLE32299Medicare UPIN