Organization
DR ALAN H SIEGEL P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN HOWARD SIEGEL O.D. (OPTOMETRIST)
(772) 335-5006
Entity
Organization
Contact information
Practice address
10692 S US HIGHWAY 1, SUITE B, PORT ST LUCIE, FL 34952-6408
(772) 335-5006
(772) 335-4672
Mailing address
10692 S US HIGHWAY 1, SUITE B, PORT ST LUCIE, FL 34952-6408
(772) 335-5006
(772) 335-4672
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC1190
FL
332H00000X
Eyewear Supplier
FL1190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111512
EYEMED
—
01
—
19745
BCBS
—
01
—
3515
DAVIS VISION
—
01
—
36080
GVA
—
01
—
4066210001
NPPES
FL
01
—
410046674
MEDICARE RR
—
01
—
5124007
AETNA
—
01
—
86030
SPECTERA
—
01
—
91471
VCA
—
01
—
AH112
MEDICARE
—
01
—
OP-0001190
WORKMAN'S COMP
—
01
—
SI142924
CLARITY
—
Enumeration date
12/21/2007
Last updated
10/29/2008
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