Organization
ELLIOT M. LIVSTONE, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLIOT M LIVSTONE MD (CEO)
(941) 955-0000
Entity
Organization
Contact information
Practice address
1515 S OSPREY AVE, SUITE C11, SARASOTA, FL 34239-2939
(941) 955-0000
Mailing address
1515 S OSPREY AVE, SUITE C11, SARASOTA, FL 34239-2939
(941) 955-0000
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0042953
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01103041
AMERIGROUP
FL
01
—
0508193
AETNA
FL
01
—
100011714
RR MEDICARE
FL
01
—
10714272
CAQH
FL
01
—
10D0955291
CLIA 10D0955291
FL
01
—
2400764
GHI
FL
01
—
58421
BC/BS
FL
01
—
6790096001
CIGNA
FL
01
—
P1647052
OXFORD
FL
Enumeration date
12/07/2009
Last updated
12/07/2009
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