MEDICARE: ROXANA LASCU MD PA

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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1407291156
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROXANA LASCU MD PA

Provider Business Mailing Address
First Line	:	PO BOX 953895
Second Line	:
City	:	LAKE MARY
State	:	FL
Zip	:	32795-3895
Country	:	US
Telephone Number	:	407-619-1990
Fax Number	:	407-804-9093

Provider Business Practice Location Address
First Line	:	1307 S INTERNATIONAL PKWY
Second Line	:	STE 1061
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1413
Country	:	US
Telephone Number	:	407-804-9090
Fax Number	:	407-804-9093

Authorized Official
Title or Position	:	OWNER
Name	:	ROXANA A LASCU
Credential	:	MD
Telephone Number	:	407-619-1990

Provider Enumeration Date	:	05/08/2013
Last Update Date	:	07/26/2013

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