| Doctor Name: | DR. CRISOSTOMO V LACANO |
| NPI Number: | 1063486819 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 29409 |
| Business Practice Address: | 110 Longwood Avenue Rockledge, FL - 32955 |
| Business Phone Number: | 3216362211 |
| Business Fax Number: | |
| Mailing Address: | Po Box 919346, ORLANDO |
| State: | FL |
| Postal Code: | 328919346 |
| Phone Number: | 7278963134 |
| Fax Number: | 7706669331 |
| NPI Enumeration Date: | 02/16/2006 |
| NPI Last Update Date: | 08/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 29409 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |