Basic Information
Provider Information | |||||||||
NPI: | 1679773725 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ISKANDAR | ||||||||
FirstName: | ALAA | ||||||||
MiddleName: | G. | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 2501 N ORANGE AVE STE 401 | ||||||||
Address2: |   | ||||||||
City: | ORLANDO | ||||||||
State: | FL | ||||||||
PostalCode: | 328044644 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4073037283 | ||||||||
FaxNumber: | 4073030475 | ||||||||
Practice Location | |||||||||
Address1: | 1876 NIGHTINGALE LN | ||||||||
Address2: |   | ||||||||
City: | TAVARES | ||||||||
State: | FL | ||||||||
PostalCode: | 327784359 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 3527424447 | ||||||||
FaxNumber: | 3527424448 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/18/2007 | ||||||||
LastUpdateDate: | 04/21/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 04/21/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0200X | ME100587 | FL | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RS0012X | ME100587 | FL | N |   | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 207RP1001X | ME100587 | FL | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.