Organization
MAURI G LUNDERMAN, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURI GLENN LUNDERMAN M.D. (OWNER/PHYSICIAN)
(850) 864-3232
Entity
Organization
Contact information
Practice address
1775 LEWIS TURNER BLVD, SUITE 102, FORT WALTON BEACH, FL 32547-1221
(850) 864-3232
(850) 864-5220
Mailing address
1775 LEWIS TURNER BLVD, SUITE 102, FORT WALTON BEACH, FL 32547-1221
(850) 864-3232
(850) 864-5220
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME64728
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
375781100
—
FL
Enumeration date
07/08/2006
Last updated
02/03/2010
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