Individual
JUAN LASTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3723 EDENBORN AVE, METAIRIE, LA 70002-1519
(504) 400-3723
(504) 885-1436
Mailing address
3723 EDENBORN AVE, METAIRIE, LA 70002-1519
(504) 400-3723
(504) 885-1436
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
016506
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1354805
—
LA
Enumeration date
07/05/2006
Last updated
08/12/2013
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