Provider Demographics
NPI: | 1093027856 |
---|---|
Name: | DIMITRIOS LINTZERIS DO, PA |
Entity Type: | Organization |
Organization Name: | DIMITRIOS LINTZERIS DO, PA |
Other - Org Name: | THE LINTZERIS MEDICAL CENTER |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | DIMITRIOS |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | LINTZERIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DO |
Authorized Official - Phone: | 561-706-5920 |
Mailing Address - Street 1: | 2980 N BEVERLY GLEN CIR |
Mailing Address - Street 2: | SUITE 301 |
Mailing Address - City: | LOS ANGELES |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90077-1726 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 310-474-9809 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1800 N FEDERAL HWY |
Practice Address - Street 2: | SUITE 207-8 |
Practice Address - City: | POMPANO BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33062-1034 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-706-5920 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | DIMITRIOS LINTZERIS DO, PA |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2010-07-09 |
Last Update Date: | 2011-03-01 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332900000X | Suppliers | Non-Pharmacy Dispensing Site |