Provider Demographics
NPI:1538431515
Name:INFUSION SERVICES OF THE TREASURE COAST INC
Entity type:Organization
Organization Name:INFUSION SERVICES OF THE TREASURE COAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN ASSISTANT AND PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:SULTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C, PHARMD
Authorized Official - Phone:772-299-7009
Mailing Address - Street 1:3735 11TH CIR STE 201
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4889
Mailing Address - Country:US
Mailing Address - Phone:772-299-7009
Mailing Address - Fax:772-562-7138
Practice Address - Street 1:3735 11TH CIR STE 201
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4889
Practice Address - Country:US
Practice Address - Phone:772-299-7009
Practice Address - Fax:772-562-7138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty