Provider Demographics
NPI:1487619847
Name:LAWRENCE C HASARA MD PLLC
Entity type:Organization
Organization Name:LAWRENCE C HASARA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:HASARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-761-8955
Mailing Address - Street 1:2225 59TH STREET
Mailing Address - Street 2:SUITE D
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7017
Mailing Address - Country:US
Mailing Address - Phone:941-761-8955
Mailing Address - Fax:941-761-8975
Practice Address - Street 1:2225 59TH STREET
Practice Address - Street 2:SUITE D
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7017
Practice Address - Country:US
Practice Address - Phone:941-761-8955
Practice Address - Fax:941-761-8975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDC0088OtherMCR RR
FL=========OtherTAX ID
FL=========OtherTAX ID