| J. Agustin Lacson M.d. Inc | |
|
3300 Us 27 S Avon Park FL 33825-9701 | |
| (863) 385-6700 | |
| Not Available |
| Full Name | J. Agustin Lacson M.d. Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3300 Us 27 S, Avon Park, Florida |
| Authorized Official Name and Position | J. Agustin Lacson (OWNER) |
| Authorized Official Contact | 8633856700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J. Agustin Lacson M.d. Inc Po Box 7514 Sebring FL 33872-0109 Ph: (863) 385-6700 | J. Agustin Lacson M.d. Inc 3300 Us 27 S Avon Park FL 33825-9701 Ph: (863) 385-6700 |
| NPI Number | 1619931821 |
|---|---|
| Provider Enumeration Date | 04/14/2006 |
| Last Update Date | 08/30/2021 |
| Medicare PECOS PAC ID | 3375434491 |
|---|---|
| Medicare Enrollment ID | O20040320000024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619931821 | NPI | - | NPPES |
| 110241195 | Other | FL | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | ME0072358 (Florida) | Primary |
| Provider Name | Juan A Lacson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1831153055 PECOS PAC ID: 9739070855 Enrollment ID: I20040320000036 |
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