MEDICARE: DR. DAVID I. LINTZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	MA25684	NJ

General Provider Information

NPI Number	:	1407848245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID I. LINTZ MD

Provider Business Mailing Address
First Line	:	8390 CHAMPIONS GATE BLVD
Second Line	:	SUITE 215
City	:	CHAMPIONS GATE
State	:	FL
Zip	:	33896-8310
Country	:	US
Telephone Number	:	407-390-1677
Fax Number	:	407-390-1765

Provider Business Practice Location Address
First Line	:	99 N LA CIENEGA BLVD
Second Line	:	SUITE 200
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2285
Country	:	US
Telephone Number	:	310-657-9353
Fax Number	:	310-657-9367

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	04/03/2017

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