Organization
MICHAEL E. LUSTGARTEN M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL E. LUSTGARTEN M.D. (OWNER)
(772) 286-2950
Entity
Organization
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
RAIL ROAD MEDICARE
FL
Enumeration date
02/24/2012
Last updated
02/24/2012
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