Basic Information
| Provider Information | |||||||||
| NPI: | 1215054697 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DR. ANHALT AND ASSOCIATES, P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 S UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544732853 | ||||||||
| FaxNumber: | 9544736506 | ||||||||
| Practice Location | |||||||||
| Address1: | 805 S UNIVERSITY DR | ||||||||
| Address2: | |||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9544732853 | ||||||||
| FaxNumber: | 9544736506 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | ANHALT | ||||||||
| AuthorizedOfficialFirstName: | STEVEN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9544732853 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | O.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152WC0802X | OPC2160 | FL | X | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | Corneal and Contact Management | 152WS0006X | OPC2160 | FL | X | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | Sports Vision | 152WX0102X | OPC2160 | FL | X | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | Occupational Vision |
No ID Information.