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General NPI Number Information
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NPI Number | 1295873222
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Entity Type | Individual
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Provider Name | FLORENCIO LAO SAM M. D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 01/29/2011
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Provider Practice Location Address
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Address Line | CAROLINA SHOPP CTR MULTIPISO OF 309 AVE 65 INFANTERIA
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City | CAROLINA
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State | PR
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Zip | 00985-5672
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Country | US
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Telephone | 787-257-1840
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Fax | 787-701-4740
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Provider Business Mailing Address
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Address Line | 138 AVE WINSTON CHURCHILL PMB 228
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City | SAN JUAN
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State | PR
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Zip | 00926-6013
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Country | US
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Telephone | 787-257-1840
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Fax | 787-701-4740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 6959 IN 1983
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License Number State | PR
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