Sustarsic, David L

Sustarsic, David L is an individual health care provider with primary practice located at 511 Medical Plaza Dr Suite 101, Leesburg FL 34748-7326. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Sustarsic, David L can be contacted via phone (352) 728-6808.

Contact Information

Primary practice address
511 Medical Plaza Dr Suite 101 Leesburg FL 34748-7326
Phone: (352) 728-6808
Fax: (352) 728-1743
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X ME43704 Florida
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X ME43704 Florida

Profile Details

NPI number 1134183130
LBN Legal business name Sustarsic, David L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2006
Last updated May 30th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1134183130 NPPES
Florida Other 35206 BLUE CROSS BLUE SHIELD
Florida MEDICAID 040867100 BLUE CROSS BLUE SHIELD

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