| Doctor Name: | GARY JAMES LUSTGARTEN, M.D.,F.A.C.S. |
| NPI Number: | 1740366368 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | ME0016186 |
| Business Practice Address: | 100 Nw 170th St Suite 302 North Miami Beach, FL - 331695513 |
| Business Phone Number: | 3056535155 |
| Business Fax Number: | 3056535513 |
| Mailing Address: | 100 Nw 170th St, Suite 302 NORTH MIAMI BEACH |
| State: | FL |
| Postal Code: | 331695513 |
| Phone Number: | 3056535155 |
| Fax Number: | 3056535513 |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | ME0016186 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |