Provider Demographics
NPI:1194727669
Name:LAPPANO, ALFRED F JR (OD)
Entity type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:F
Last Name:LAPPANO
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:10751 MAPLE CREEK DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TRINITY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-4412
Mailing Address - Country:US
Mailing Address - Phone:727-375-8442
Mailing Address - Fax:727-375-0942
Practice Address - Street 1:10751 MAPLE CREEK DR
Practice Address - Street 2:SUITE 104
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4412
Practice Address - Country:US
Practice Address - Phone:727-375-8442
Practice Address - Fax:727-375-0942
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOPC1667152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL078745100Medicaid
FL19858ZMedicare ID - Type UnspecifiedOAF GROUP K0738
FL078745100Medicaid
U93920Medicare UPIN