Individual
DR. LOUIS DEMBRUN MATHERNE IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4211 VAN DYKE RD STE 200, LUTZ, FL 33558-8005
(813) 264-6490
(813) 443-8143
Mailing address
4211 VAN DYKE RD STE 200, LUTZ, FL 33558-8005
(813) 264-6490
(813) 443-8143
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
51640
KY
208600000X
Surgery Physician
Primary
ME141420
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104739400
—
FL
Enumeration date
06/02/2011
Last updated
07/11/2022
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