Individual
DR. KASEY LAZ ABANONU JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4919 W CRAIG RD, LAS VEGAS, NV 89130-2730
(725) 220-8706
(833) 749-0366
Mailing address
4700 MILLENIA BLVD STE 650, ORLANDO, FL 32839-6013
(725) 220-8706
(833) 749-0366
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
14139
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609109644
—
NV
01
—
V75834
MEDICARE
NV
Enumeration date
09/09/2009
Last updated
12/02/2022
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