Provider Demographics
NPI:1528035706
Name:LAMBIASO, MARLENE K (MD)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:K
Last Name:LAMBIASO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:658 CAYUGA DR
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5603
Mailing Address - Country:US
Mailing Address - Phone:407-359-2213
Mailing Address - Fax:
Practice Address - Street 1:2555 S. KIRKMAN ROAD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811
Practice Address - Country:US
Practice Address - Phone:407-362-2030
Practice Address - Fax:407-363-2143
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME417812083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593607609OtherTAX ID
FL38907Medicare ID - Type Unspecified
FL593607609OtherTAX ID