Provider Demographics
NPI:1922161025
Name:LAGUNDINO, FLORDELINO CIMATU SR (MD)
Entity Type:Individual
Prefix:DR
First Name:FLORDELINO
Middle Name:CIMATU
Last Name:LAGUNDINO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1529 INTERNATIONAL BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23513-4802
Mailing Address - Country:US
Mailing Address - Phone:757-214-9230
Mailing Address - Fax:757-855-6050
Practice Address - Street 1:1529 INTERNATIONAL BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23513-4802
Practice Address - Country:US
Practice Address - Phone:757-214-9230
Practice Address - Fax:757-855-6050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101027784208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA541043858Medicaid