MEDICARE: DR. KATHRYN JO LAGO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	02004556A	IN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RI0200X	Infectious Disease Physician	OS20931	FL
4	207RI0200X	Infectious Disease Physician	02004556A	IN

General Provider Information

NPI Number	:	1194067496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN JO LAGO D.O.

Provider Business Mailing Address
First Line	:	1425 S OSPREY AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-2938
Country	:	US
Telephone Number	:	941-366-9060
Fax Number	:	941-953-7076

Provider Business Practice Location Address
First Line	:	1425 S OSPREY AVE
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34239-2938
Country	:	US
Telephone Number	:	941-366-9060
Fax Number	:	941-953-7076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2013
Last Update Date	:	08/15/2024

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