Basic Information
Provider Information
NPI: 1487658910
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANCASTER
FirstName: STEVEN
MiddleName: J.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1325 SAN MARCO BLVD
Address2: SUITE 200
City: JACKSONVILLE
State: FL
PostalCode: 322078568
CountryCode: US
TelephoneNumber: 9043463465
FaxNumber: 9048586489
Practice Location
Address1: 1577 ROBERTS DR
Address2: SUITE 225 & 226
City: JACKSONVILLE BEACH
State: FL
PostalCode: 322503264
CountryCode: US
TelephoneNumber: 9042411204
FaxNumber: 9042417331
Other Information
ProviderEnumerationDate: 06/13/2005
LastUpdateDate: 04/18/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XME42453FLY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106XME42453FLN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207XS0114XME42453FLN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
207XX0005XME42453FLN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

ID Information
IDTypeStateIssuerDescription
20000412101FLRAILROAD MEDICAREOTHER
06950090005FL MEDICAID


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