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Search › Florida › 207N00000X

Edward Lack, MD

NPI 1417955584 · on the registry since 2005

Practice

Address
540 Medical Oaks Ave
Suite 102
Brandon, FL 33511
Phone
(813) 651-1991
Fax
(813) 651-1401
Organisation at this address
Brandon Eye Associates Pa
Leavitt Medical Associates Of Florida Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
13

Registry record

Primary taxonomy
207N00000X
207N00000X
Also registered as
207N00000X
Licence states on file
IL, FL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2016-11-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Florida