Mark W. Lastarza, M.D., PA.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME75627 Issued in FL

Legal business name

MARK W. LASTARZA, M.D., PA.

Practice address

335 Clyde Morris Blvd
Suite 290
Ormond Beach, FL 32174-3181

Phone

(386) 672-3219

Fax

(386) 672-3160

NPI assigned

Jun 3, 2014

Last updated

Feb 25, 2016By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Lastarza, M.D.NPI 1831165448

Title

Director

Phone

(386) 672-3219

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark W. Lastarza, M.D.

  • Internal Medicine Physician
  • Ormond Beach, FL
  • NPI 1831165448
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1043623598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 290",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743181",
            "telephone_number": "386-672-3219",
            "fax_number": "386-672-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 CLYDE MORRIS BLVD",
            "address_2": "SUITE 290",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321743181",
            "telephone_number": "386-672-3219",
            "fax_number": "386-672-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK W. LASTARZA, M.D., PA.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "LASTARZA",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "386-672-3219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME75627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcie Marandino, D.C.
• Enzo Marchese, EMT
• Kelli Jean Marchewka, PA-C
• Jenilee Marcinkiewicz, FNP-C
• Rita Marino, LMHC
• Holly A Marocchi, RRT, AE-C
• Daniel Joseph Marshall
• Richard J. Marshall, PA
• Arlenys Marte
• Erica Anne Martin

• Internal Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.