Provider Demographics
NPI:1164258257
Name:BONACHI VERGAMINI, LUCAS (MD)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:
Last Name:BONACHI VERGAMINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:3901 RAINBOW BLVD # MS 3016
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-3173
Mailing Address - Fax:913-588-7625
Practice Address - Street 1:3901 RAINBOW BLVD # MS 3016
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-1330
Practice Address - Country:US
Practice Address - Phone:913-588-3173
Practice Address - Fax:913-588-7625
Is Sole Proprietor?:No
Enumeration Date:2024-09-13
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94-12150208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology