Healthcare Provider Details

I. General information

NPI: 1619183753
Provider Name (Legal Business Name): STERLING PLASTIC & RECONSTRUCTIVE SURGEONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8800 S TAMIAMI TRL STE A
SARASOTA FL
34238
US

IV. Provider business mailing address

PO BOX 19596
BELFAST ME
04915-4090
US

V. Phone/Fax

Practice location:
  • Phone: 941-918-8330
  • Fax: 941-918-8332
Mailing address:
  • Phone: 941-918-8330
  • Fax: 941-918-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK EUGENE MATHIESON
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 941-918-8800