Healthcare Provider Details

I. General information

NPI: 1609826734
Provider Name (Legal Business Name): MARK. B. LONSTEIN M.D.P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2032 HILLVIEW ST
SARASOTA FL
34239-2334
US

IV. Provider business mailing address

2032 HILLVIEW ST
SARASOTA FL
34239-2334
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-6500
  • Fax: 941-917-6504
Mailing address:
  • Phone: 941-917-6500
  • Fax: 941-917-6504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK B LONSTEIN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 941-917-6500