Lastarza, Mark W.

Lastarza, Mark W. is an individual health care provider with primary practice located at 335 Clyde Morris Blvd Suite 290, Ormond Beach FL 32174-5959. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lastarza, Mark W. can be contacted via phone (386) 672-3219.

Contact Information

Primary practice address
335 Clyde Morris Blvd Suite 290 Ormond Beach FL 32174-5959
Phone: (386) 672-3219
Fax: (386) 672-3160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X ME0075627 Florida

Profile Details

NPI number 1831165448
LBN Legal business name Lastarza, Mark W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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