Individual
ANTONIO M LAZCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3003
(352) 265-7999
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35049284
OH
207P00000X
Emergency Medicine Physician
Primary
ME108060
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002817800
—
FL
05
—
0551157
—
OH
Enumeration date
02/27/2006
Last updated
10/26/2012
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