Provider Demographics
NPI:1548374663
Name:MASSARO, LANA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LANA
Middle Name:ANN
Last Name:MASSARO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LANA
Other - Middle Name:A
Other - Last Name:DOXTATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:755 RINEHART RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4886
Mailing Address - Country:US
Mailing Address - Phone:407-320-8100
Mailing Address - Fax:407-320-8110
Practice Address - Street 1:755 RINEHART RD STE 200
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-4886
Practice Address - Country:US
Practice Address - Phone:407-320-8100
Practice Address - Fax:407-320-8110
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50091-20207Q00000X
FLME120852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine