Mr. Edward B Lack, MD
Mr. Edward B Lack, MD is a Dermatology Physician in Brandon, Florida. Licensed in Florida and Illinois. Registered with an NPI since 2005.
- Licensed in
- FL, IL
- In the registry since
- 2005
- Specialties on file
- 2
What do these letters mean?
- MD — Doctor of Medicine
- A physician who completed allopathic medical school.
Practice location Address checks out
540 Medical Oaks Ave Ste 102Brandon, FL 33511-5995
Phone: (813) 651-1991
Fax: (813) 651-1401
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence 036-043409 (IL) |
|---|---|
| Dermatology Physician | Taxonomy 207N00000X · Licence ME114654 (FL) |
Record details
| NPI number | 1417955584 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | MD |
| Sole proprietor | No |
| NPI enumerated | July 12, 2005 |
| Last updated in NPPES | November 15, 2016 |
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