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Organization
R. R.LASTOMIRSKY, M.D., P.A.
Active
Organization
R. R.LASTOMIRSKY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT RAYMOND LASTOMIRSKY M.D. (OWNER/OPERATOR)
(941) 484-8414
Entity
Organization
Contact information
Practice address
740 THE RIALTO, VENICE, FL 34285-3524
(941) 484-8414
(941) 488-7586
Mailing address
740 THE RIALTO, P. O. BOX 1803, VENICE, FL 34285-3524
(941) 484-8414
(941) 488-7586
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME0032829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306860382
NPI PHYSICIAN NUMBER
FL
01
—
ME0032829
STATE LISCENSE NUMBER
FL
Enumeration date
09/13/2006
Last updated
12/04/2007
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