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Individual

DR. EVAN M. LANDAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1600 S ANDREWS AVE, FORT LAUDERDALE, FL 33316-2510
(954) 355-5365
(954) 468-5251
Mailing address
2234 COLONIAL BLVD, ATTN: PAYER CONTRACTING & RELATIONS, FORT MYERS, FL 33907-1412
(239) 931-7342
(239) 931-7385

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
243554
NY
2085R0001X
Radiation Oncology Physician
Primary
ME109336
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003841600
FL
01
01671620
AMERIGROUP
FL
01
14EC7
BCBS FL
FL
01
2295602
GHI
FL
01
23340
MEDICA
FL
01
2810412
CIGNA
FL
01
349267
AVMED
FL
01
662325
WELLCARE
FL
01
7422
DIMENSIONS
FL
01
9414789
AETNA
FL
01
F00335716002
UNITED HEALTHCARE
FL
01
P0003152
FLORIDA HEALTHCARE PLUS
FL
01
P00990539
RAILROAD MEDICARE
FL
01
P938024
OPTIMUN
FL
01
P997247
FREEDOM HEALTH
FL
Enumeration date
07/19/2007
Last updated
11/29/2012
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