Individual
JORGE ENRIQUE LASCANO
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) 265-0651
Mailing address
PO BOX 918025, ORLANDO, FL 32891-8025
(352) 265-0651
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
ME97057
FL
207RP1001X
Pulmonary Disease Physician
ME97057
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002467600
—
FL
Enumeration date
05/29/2007
Last updated
11/01/2010
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