Basic Information
| Provider Information | |||||||||
| NPI: | 1184629321 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ALPERS | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2230 SW 19TH AVENUE RD | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344711391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522374133 | ||||||||
| FaxNumber: | 3522377728 | ||||||||
| Practice Location | |||||||||
| Address1: | 2230 SW 19TH AVENUE RD | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344711391 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522374133 | ||||||||
| FaxNumber: | 3522377728 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2005 | ||||||||
| LastUpdateDate: | 01/12/2011 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 03/17/2006 | ||||||||
| NPIReactivationDate: | 03/24/2006 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207QA0505X | OS6081 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine | Adult Medicine |
ID Information
| ID | Type | State | Issuer | Description | 260623200 | 05 | FL | MEDICAID |