Provider Demographics
NPI:1891917779
Name:CONSTANT, DOUGLAS LIONEL (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:LIONEL
Last Name:CONSTANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:8000 SR 64 E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34212
Mailing Address - Country:US
Mailing Address - Phone:941-792-1404
Mailing Address - Fax:941-795-1717
Practice Address - Street 1:5741 BEE RIDGE RD STE 450
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5081
Practice Address - Country:US
Practice Address - Phone:941-951-2663
Practice Address - Fax:941-552-3312
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME108659207LP2900X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEV495YMedicare PIN