Provider Demographics
NPI:1508990334
Name:ALTAMONTE MEDICAL ASSOCIATE, P.A.
Entity Type:Organization
Organization Name:ALTAMONTE MEDICAL ASSOCIATE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:STURN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-339-5600
Mailing Address - Street 1:631 PALM SPRINGS DR
Mailing Address - Street 2:SUITE 117
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-7854
Mailing Address - Country:US
Mailing Address - Phone:407-339-5600
Mailing Address - Fax:407-339-5602
Practice Address - Street 1:631 PALM SPRINGS DR
Practice Address - Street 2:SUITE 117
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-7854
Practice Address - Country:US
Practice Address - Phone:407-339-5600
Practice Address - Fax:407-339-5602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3906Medicare ID - Type Unspecified