Carl W Lentz III, M.D., P.a.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME0023708 Issued in FL

Legal business name

CARL W LENTZ III, M.D., P.A.

Practice address

1265 W Granada Blvd
Suite 3
Ormond Beach, FL 32174

Phone

(386) 252-8051

Fax

(386) 252-1173

NPI assigned

Nov 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Carl W Lentz III, M.D.

Title

President

Phone

(386) 252-8051

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497484800000",
    "number": "1487836698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 W GRANADA BLVD",
            "address_2": "SUITE 3",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-252-8051",
            "fax_number": "386-252-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 W GRANADA BLVD",
            "address_2": "SUITE 3",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "32174",
            "telephone_number": "386-252-8051",
            "fax_number": "386-252-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL W LENTZ III, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2017-06-15",
        "status": "A",
        "authorized_official_last_name": "LENTZ",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-252-8051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME0023708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.