Provider Demographics
NPI:1154976017
Name:LAZO MOJENA, CARMEN (PSYCHOLOGIST)
Entity type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:
Last Name:LAZO MOJENA
Suffix:
Gender:F
Credentials:PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 VALENCIA AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5750
Mailing Address - Country:US
Mailing Address - Phone:786-314-2894
Mailing Address - Fax:
Practice Address - Street 1:250 CATALONIA AVE STE 305
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-6730
Practice Address - Country:US
Practice Address - Phone:305-445-5981
Practice Address - Fax:305-445-5982
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist