Individual
PHILIP LACSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
18100 NE 19TH AVE, #102, NORTH MIAMI BEACH, FL 33162-1606
(305) 949-6003
(305) 948-3911
Mailing address
18100 NE 19TH AVE, #102, NORTH MIAMI BEACH, FL 33162-1606
(305) 949-6003
(305) 948-3911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 9107668
FL
363AM0700X
Medical Physician Assistant
Primary
PA 9107668
FL
Other
Enumeration date
11/26/2013
Last updated
04/12/2015
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