Basic Information
Provider Information
NPI: 1457906794
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ADLER
FirstName: ALANA
MiddleName: HOPE
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: RUBENSTEIN
OtherFirstName: ALANA
OtherMiddleName: HOPE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 13691 METRO PKWY STE 130
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339124321
CountryCode: US
TelephoneNumber: 2393493539
FaxNumber: 2392177469
Practice Location
Address1: 13691 METRO PKWY STE 130
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339124321
CountryCode: US
TelephoneNumber: 2393493539
FaxNumber: 2392177469
Other Information
ProviderEnumerationDate: 08/05/2019
LastUpdateDate: 09/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XAPRN11001967FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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