Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME61325 | FL |
NPI | 1093898546 |
---|---|
Provider Name | Dr. William Lonzo Lasswell |
First Address | Vero Beach, FL 32960 |
Second Address | Vero Beach, FL 32960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G00555 | (02) | FL |