Individual
DR. DAVID L SUSTARSIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
511 MEDICAL PLAZA DR, SUITE 101, LEESBURG, FL 34748-7326
(352) 728-6808
(352) 728-1743
Mailing address
511 MEDICAL PLAZA DR, SUITE 101, LEESBURG, FL 34748-7326
(352) 728-6808
(352) 728-1743
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME43704
FL
2086S0129X
Vascular Surgery Physician
ME43704
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040867100
—
FL
01
—
35206
BLUE CROSS BLUE SHIELD
FL
Enumeration date
04/14/2006
Last updated
05/30/2012
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