Provider Demographics
NPI:1780633107
Name:LINDBERG, HARALD LAURITZ (MD)
Entity Type:Individual
Prefix:
First Name:HARALD
Middle Name:LAURITZ
Last Name:LINDBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 7TH ST S
Mailing Address - Street 2:STE 450
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4719
Mailing Address - Country:US
Mailing Address - Phone:727-822-6666
Mailing Address - Fax:727-821-5994
Practice Address - Street 1:603 7TH ST S
Practice Address - Street 2:STE 450
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4719
Practice Address - Country:US
Practice Address - Phone:727-822-6666
Practice Address - Fax:727-821-5994
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1584208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1684684OtherCIGNA
FL301737OtherAVMED
FL1684684OtherCIGNA