Healthcare Provider Details

I. General information

NPI: 1780633107
Provider Name (Legal Business Name): HARALD LAURITZ LINDBERG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 7TH ST S STE 450
ST PETERSBURG FL
33701-4719
US

IV. Provider business mailing address

603 7TH ST S STE 450
ST PETERSBURG FL
33701-4719
US

V. Phone/Fax

Practice location:
  • Phone: 727-822-6666
  • Fax: 727-821-5994
Mailing address:
  • Phone: 727-822-6666
  • Fax: 727-821-5994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number1584
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: