Individual
MARK A. LAGATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 METRIC DR, SUITE 200, WINTER PARK, FL 32792-6832
(407) 681-8720
(407) 681-8729
Mailing address
807 S ORLANDO AVE, SUITE C, WINTER PARK, FL 32789-4870
(407) 894-4693
(407) 539-0469
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME0073930
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260724700
—
FL
01
—
276417
AVMED
FL
01
—
390007737
RAILROAD MEDICARE
FL
01
—
42654
BCBS
FL
Enumeration date
08/24/2005
Last updated
12/23/2009
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