Provider Demographics
NPI:1942471172
Name:GUY P LAFOND MD PA
Entity Type:Organization
Organization Name:GUY P LAFOND MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GUY
Authorized Official - Middle Name:P
Authorized Official - Last Name:LAFOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-581-2586
Mailing Address - Street 1:220 POINCIANA LN
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-2615
Mailing Address - Country:US
Mailing Address - Phone:727-581-2586
Mailing Address - Fax:727-581-2586
Practice Address - Street 1:220 POINCIANA LN
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33770-2615
Practice Address - Country:US
Practice Address - Phone:727-581-2586
Practice Address - Fax:727-581-2586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-15
Last Update Date:2012-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME51822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0073OtherMEDICARE B