Provider Demographics
NPI:1215956289
Name:LASKER, JAMES C (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:LASKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3555 10TH CT STE 200B
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5013
Mailing Address - Country:US
Mailing Address - Phone:772-563-4673
Mailing Address - Fax:
Practice Address - Street 1:3555 10TH CT # 200B
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-5013
Practice Address - Country:US
Practice Address - Phone:772-563-4673
Practice Address - Fax:772-770-6821
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL20063207RH0003X
FLME62280207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL0000051392Medicaid
AL000008942Medicaid
AL000008942Medicaid
AL000008942Medicare PIN
ALD45902Medicare UPIN