Healthcare Provider Details

I. General information

NPI: 1760688311
Provider Name (Legal Business Name): MICHAEL LAFUENTE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 BAYOU PINES EAST DR
LAKE CHARLES LA
70601-7184
US

IV. Provider business mailing address

750 BAYOU PINES EAST DR
LAKE CHARLES LA
70601-7184
US

V. Phone/Fax

Practice location:
  • Phone: 866-328-8346
  • Fax: 706-854-2149
Mailing address:
  • Phone: 866-328-8346
  • Fax: 706-854-3333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD.201503
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberQ4621
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35144219
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberQ4621
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number201503
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: