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Organization

COMPREHENSIVE EAR NOSE THROAT ALLERGY SINUS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DEAN R LINDSTROM III MD (OWNER)
(321) 802-6697
Entity
Organization

Contact information

Practice address
1314 PINE ST, MELBOURNE, FL 32901-3117
(321) 802-6697
(321) 802-3158
Mailing address
1314 PINE ST, MELBOURNE, FL 32901-3117
(321) 802-6697
(321) 802-3158

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME111877
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004547400
FL
01
FV242
MEDICARE PTAN
FL
Enumeration date
03/14/2016
Last updated
03/14/2016
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