Provider Demographics
NPI:1770515918
Name:LASCARI, ROLAND (MD)
Entity type:Individual
Prefix:
First Name:ROLAND
Middle Name:
Last Name:LASCARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1515 S OSPREY AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2939
Practice Address - Country:US
Practice Address - Phone:941-917-7197
Practice Address - Fax:941-917-4016
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2016-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04187300207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0409464OtherEVERCARE
5221142040OtherBCBS OF NJ
C55008Medicare UPIN
080188745Medicare PIN
0409464OtherEVERCARE
P00448657Medicare PIN
449963XNMMedicare PIN