Provider Demographics
NPI:1770538845
Name:LASNER, JAY (MD)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:LASNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 EMERALD AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-4429
Mailing Address - Country:US
Mailing Address - Phone:954-501-7800
Mailing Address - Fax:954-722-6996
Practice Address - Street 1:8100 EMERALD AVE
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33076-4429
Practice Address - Country:US
Practice Address - Phone:954-501-7800
Practice Address - Fax:954-722-6996
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70674207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A93322Medicare UPIN
FL31308Medicare PIN