Healthcare Provider Details

I. General information

NPI: 1770515918
Provider Name (Legal Business Name): ROLAND LASCARI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S OSPREY AVE SUITE 1A
SARASOTA FL
34239-2939
US

IV. Provider business mailing address

PO BOX 863407
ORLANDO FL
32886-3407
US

V. Phone/Fax

Practice location:
  • Phone: 941-917-7197
  • Fax: 941-917-4016
Mailing address:
  • Phone: 941-917-2600
  • Fax: 941-917-7884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA04187300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: