Provider Demographics
NPI:1780609065
Name:WEINTRAUB, ALAN M (MD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:M
Last Name:WEINTRAUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3001 EXECUTIVE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-5323
Mailing Address - Country:US
Mailing Address - Phone:727-347-0005
Mailing Address - Fax:275-416-5587
Practice Address - Street 1:4108 HENDERSON BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-5750
Practice Address - Country:US
Practice Address - Phone:813-289-4321
Practice Address - Fax:813-247-2949
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2021-05-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME59366207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11969OtherBCBS
FL052618500Medicaid
FL0004389OtherUNITED
FL110178341OtherRAILROAD
FL0004389OtherUNITED
FL11969OtherBCBS