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Individual

DR. CHARLES PETER LAGO SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
350 N PINE ISLAND RD, SUITE 300, PLANTATION, FL 33324-1849
(954) 236-5444
(954) 236-5422
Mailing address
PO BOX 15466, PLANTATION, FL 33318-5466
(954) 236-5444
(954) 236-5422

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
ME66163
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1002966
CARE PLUS
FL
01
1380688
UNITED HEALTHCARE
FL
01
201272
AMERI GROUP
FL
01
202325
AVMED
FL
01
26971
BLUE CROSS BLUE SHIELD
FL
01
3392686
AETNA HMO
FL
01
378125900
TCA
FL
05
378125900
FL
01
5334
N H P
FL
01
5578459
AETNA PPO
FL
Enumeration date
10/19/2005
Last updated
06/17/2010
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