Provider Demographics
NPI:1831325984
Name:LACZI, JOSEPH BARTOLOMEU (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BARTOLOMEU
Last Name:LACZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOSIF
Other - Middle Name:BARTOLOMEU
Other - Last Name:LACZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1329 N COLLIER BLVD
Mailing Address - Street 2:
Mailing Address - City:MARCO ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:34145-2342
Mailing Address - Country:US
Mailing Address - Phone:570-233-8625
Mailing Address - Fax:
Practice Address - Street 1:1329 N. COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-2342
Practice Address - Country:US
Practice Address - Phone:570-233-8625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030614Y207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine