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Individual

DR. ANTON ERIKOVICH LOTMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1155 35TH LN STE 100B, VERO BEACH, FL 32960-6521
(772) 770-6848
Mailing address
5915 SUMMERSWEET LN, VERO BEACH, FL 32967-6073
(541) 297-1665

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
26134
OR
2084N0400X
Neurology Physician
Primary
ME167400
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
026822
OR
05
121920100
FL
01
1407812365
MEDICARE GROUP NPI
OR
01
930635514
TAX ID
OR
01
930802343
TAX ID#
OR
01
ME167400
FLORIDA MEDICAL LICENSE
FL
01
R0000WFBTV
MEDICARE GROUP PIN
OR
Enumeration date
09/07/2005
Last updated
06/24/2025
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