Provider Demographics
NPI:1942527718
Name:JEFFREY M. LASKOFF, M.D., P.A.
Entity Type:Organization
Organization Name:JEFFREY M. LASKOFF, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENET
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LASKOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-841-3620
Mailing Address - Street 1:1502 LUCERNE TER
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-2017
Mailing Address - Country:US
Mailing Address - Phone:407-841-3620
Mailing Address - Fax:407-843-8423
Practice Address - Street 1:1502 LUCERNE TER
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2017
Practice Address - Country:US
Practice Address - Phone:407-841-3620
Practice Address - Fax:407-843-8423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME23702174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL056568700Medicaid
FL056568700Medicaid
FLD58184Medicare UPIN