Healthcare Provider Details

I. General information

NPI: 1528035706
Provider Name (Legal Business Name): MARLENE K LAMBIASO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2006
Last Update Date: 06/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 S. KIRKMAN ROAD
ORLANDO FL
32811
US

IV. Provider business mailing address

658 CAYUGA DR
WINTER SPRINGS FL
32708-5603
US

V. Phone/Fax

Practice location:
  • Phone: 407-362-2030
  • Fax: 407-363-2143
Mailing address:
  • Phone: 407-359-2213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberME41781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: