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Individual

DR. ALAN FRED SHADER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3800 WEST 12TH AVE, HIALEAH, FL 33012
(305) 681-2600
(305) 685-5098
Mailing address
3800 W 12TH AVE, HIALEAH, FL 33012-7793
(305) 681-2600
(305) 685-0906

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO001468
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0410985000
FL
05
9000141973
CO
01
P01770676
RAILROAD MEDICARE
CO
Enumeration date
08/30/2006
Last updated
03/07/2017
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