Basic Information
Provider Information
NPI: 1407848245
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LINTZ
FirstName: DAVID
MiddleName: I.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8390 CHAMPIONS GATE BLVD
Address2: SUITE 215
City: CHAMPIONS GATE
State: FL
PostalCode: 338968310
CountryCode: US
TelephoneNumber: 4073901677
FaxNumber: 4073901765
Practice Location
Address1: 99 N LA CIENEGA BLVD
Address2: SUITE 200
City: BEVERLY HILLS
State: CA
PostalCode: 902112285
CountryCode: US
TelephoneNumber: 3106579353
FaxNumber: 3106579367
Other Information
ProviderEnumerationDate: 08/18/2005
LastUpdateDate: 04/03/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200XMA25684NJY Allopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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