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General NPI Number Information
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NPI Number | 1437152824
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Entity Type | Individual
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Provider Name | VINCENT A LAGANELLA D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2005
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 10141 BIG BEND RD SUITE 101
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City | RIVERVIEW
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State | FL
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Zip | 33578-7419
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Country | US
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Telephone | 813-397-1270
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Fax | 813-397-1271
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Provider Business Mailing Address
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Address Line | PO BOX 743409
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City | ATLANTA
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State | GA
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Zip | 30374-3409
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Country | US
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Telephone | 727-532-0002
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Fax | 727-532-1325
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8133
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License Number State | FL
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