DPN-FL PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DPN-FL PA

Practice address

13517 Deep Blue PL
Bradenton, FL 34211-4129

Phone

(313) 329-2646

NPI assigned

Feb 20, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dominick Lago, MD

Title

President

Phone

(248) 631-9171

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676851200000",
    "number": "1750089728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13517 DEEP BLUE PL",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13517 DEEP BLUE PL",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114129",
            "telephone_number": "313-329-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DPN-FL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A",
        "authorized_official_last_name": "LAGO",
        "authorized_official_first_name": "DOMINICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-631-9171",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.