MEDICARE: DR LANCASTER & ASSOCIATES 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	122300000X	Dentist	20360	FL

General Provider Information

NPI Number	:	1679943898
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR LANCASTER & ASSOCIATES PA

Provider Business Mailing Address
First Line	:	1349 S INTERNATIONAL PKWY
Second Line	:	SUITE 1441
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1697
Country	:	US
Telephone Number	:	321-368-8538
Fax Number	:

Provider Business Practice Location Address
First Line	:	1349 S INTERNATIONAL PKWY
Second Line	:	SUITE 1441
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1697
Country	:	US
Telephone Number	:	321-368-8538
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	DR. EDWARD ELI LANCASTER III
Credential	:	DMD
Telephone Number	:	321-368-8538

Provider Enumeration Date	:	09/30/2015
Last Update Date	:	02/21/2017

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