Individual
DR. LAURA WASYLENKO BANCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
512 NOKOMIS AVE S, VENICE, FL 34285-2817
(941) 488-7781
(941) 486-8991
Mailing address
512 NOKOMIS AVE S, VENICE, FL 34285-2817
(941) 488-7781
(941) 486-8991
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME65440
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268756900
—
FL
01
—
28439
BLUECROSS/BLUESHIELD
FL
01
—
300055808
RAILROAD MEDICARE
FL
Enumeration date
10/29/2005
Last updated
01/15/2026
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