Provider Demographics
NPI:1396233821
Name:GARCIA, LAZARO (ARNP)
Entity type:Individual
Prefix:
First Name:LAZARO
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 N ROYAL POINCIANA BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4434
Mailing Address - Country:US
Mailing Address - Phone:305-351-6785
Mailing Address - Fax:
Practice Address - Street 1:156 N ROYAL POINCIANA BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33166-4434
Practice Address - Country:US
Practice Address - Phone:305-351-6785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9229858363L00000X
FLARNP9229858363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner