Organization
ABELARDO V. LACANO, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABELARDO VASQUEZ LACANO M.D. (PRESIDENT)
(321) 452-8410
Entity
Organization
Contact information
Practice address
300 FORTENBERRY RD, MERRITT ISLAND, FL 32952-3621
(321) 452-8410
(321) 453-4938
Mailing address
300 FORTENBERRY RD, MERRITT ISLAND, FL 32952-3621
(321) 452-8410
(321) 453-4938
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME 20168
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05312
BLUE CROSS BLUE SHIELD
FL
01
—
4205733
AETNA
FL
Enumeration date
04/02/2007
Last updated
08/22/2020
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