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Lucas
Lucas
Rabeno fasolo
Medical doctor
North Miami Beach, United States
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Reveal information
Florida Health Care Practitioner Data Portal
Full name
Lucas Rabeno Fasolo
Job Title
Medical Doctor
Location
North Miami Beach, FL, USA
LIC ID
156936
Current License Expiration Date
31/01/2026
Original Date
14/09/2021
Professional Rank Code
ME
Effective Date
14/09/2021
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
MIAMI-DADE
Mailing Address Line 2
Unit 820
Practice Location Address Line 1
4692 NW 183rd St
Practice Location Address Line 2
Chen Senior Medical Center - Carol City
Practice Location Address City
MIAMI GARDENS
Practice Location Address State
FL
Practice Location Address Zipcode
33055
Mode Code
Dispensing Practitioner
Prescribing Indicator
N
Dispensing Indicator
Y
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