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Individual

MICHAEL EMORY LUSTGARTEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
834 E OCEAN BLVD, STUART, FL 34994-2428
(772) 286-2950
(772) 286-2339
Mailing address
834 E OCEAN BLVD, STUART, FL 34994-2428
(772) 286-2950
(772) 286-2339

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0036091
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
065662300
FL
01
340000180
RAILROAD MEDICARE
FL
Enumeration date
11/15/2005
Last updated
10/21/2010
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