MARK W. LASTARZA, M.D., PA.
Osteopathic Medicine at Clyde Morris Blvd, Ormond Beach, FL

License number
Florida ME75627
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. MARK LASTARZA M.D.
Title: DIRECTOR
Phone: (386) 672-3219
Address
Address
335 Clyde Morris Blvd SUITE 290, Ormond Beach, FL 32174
National Provider ID: 1043623598
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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Mark W. Lastarza, M.D., PA

335 Clyde Morris Blvd, Ormond Beach, FL 32174

Registration:
Jul 30, 2001
State ID:
P01000076127
Business type:
Domestic for Profit Corporation
Director:
Mark W. Lastarza (Director)

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