Provider Demographics
NPI:1689245011
Name:DR. G. MARK LASKERR AND ASSOCIATES, O.D., P.A.
Entity Type:Organization
Organization Name:DR. G. MARK LASKERR AND ASSOCIATES, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:LASKERR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:813-713-6936
Mailing Address - Street 1:25812 GOLDTREE CT
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-5113
Mailing Address - Country:US
Mailing Address - Phone:813-713-6936
Mailing Address - Fax:863-413-0227
Practice Address - Street 1:1929A W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4813
Practice Address - Country:US
Practice Address - Phone:813-662-2200
Practice Address - Fax:813-662-2140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Multi-Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Multi-Specialty