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Individual

DR. ALAN HOWARD SIEGEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

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
OPC 1190
FL
332H00000X
Eyewear Supplier
1190
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111512
ECPA-EYEMED
FL
01
19745
BCBS
FL
01
3515
DAVIS VISION
01
36080
GVA
01
4066210001
PALMETTO
01
410046674
MEDICARE RR
01
5124007
AETNA
FL
01
86030
SPECTERA
01
91471
VCA
01
OP-0001190
WORKMANS COMP
01
SI142924
CLARITY VISION
Enumeration date
11/13/2006
Last updated
02/27/2017
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