Provider Demographics
NPI:1700162385
Name:LASATER, CHERYL LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:LYNN
Last Name:LASATER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 85001 DEPT 217
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32885-0217
Mailing Address - Country:US
Mailing Address - Phone:941-354-1950
Mailing Address - Fax:941-345-1951
Practice Address - Street 1:4351 CORTEZ RD W STE 200
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3217
Practice Address - Country:US
Practice Address - Phone:941-345-1950
Practice Address - Fax:941-345-1951
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL2950612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFR337ZMedicare PIN