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Organization
MARK W. LASTARZA, M.D., PA.
Active
Organization
MARK W. LASTARZA, M.D., PA.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK LASTARZA M.D. (DIRECTOR)
(386) 672-3219
Entity
Organization
Contact information
Practice address
335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL 32174-3181
(386) 672-3219
(386) 672-3160
Mailing address
335 CLYDE MORRIS BLVD, SUITE 290, ORMOND BEACH, FL 32174-3181
(386) 672-3219
(386) 672-3160
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME75627
FL
Other
Enumeration date
06/03/2014
Last updated
02/25/2016
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