Mauri G Lunderman, M.D., P.a.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

ME64728 Issued in FL

Legal business name

MAURI G LUNDERMAN, M.D., P.A.

Practice address

1775 Lewis Turner Blvd
Suite 102
Fort Walton Beach, FL 32547-1221

Phone

(850) 864-3232

Fax

(850) 864-5220

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mauri Glenn Lunderman, M.D.

Title

Owner/Physician

Phone

(850) 864-3232

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18836/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265155200000",
    "number": "1902839798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 LEWIS TURNER BLVD",
            "address_2": "SUITE 102",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471221",
            "telephone_number": "850-864-3232",
            "fax_number": "850-864-5220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 LEWIS TURNER BLVD",
            "address_2": "SUITE 102",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471221",
            "telephone_number": "850-864-3232",
            "fax_number": "850-864-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURI G LUNDERMAN, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-02-03",
        "status": "A",
        "authorized_official_last_name": "LUNDERMAN",
        "authorized_official_first_name": "MAURI",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "850-864-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME64728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "375781100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kelly Micaela Mayor, MSW, LCSW
• Robert Eugene Mayor II, LMHC
• Tamara Joanne Mays, M.S., CCC-SLP, BCBA

• Surgery Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.