Provider Demographics
NPI:1932442399
Name:FUENTES LAZZARINI, ANDRES A (DC)
Entity type:Individual
Prefix:DR
First Name:ANDRES
Middle Name:A
Last Name:FUENTES LAZZARINI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CALLE PRENDA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-6008
Mailing Address - Country:US
Mailing Address - Phone:787-240-3672
Mailing Address - Fax:
Practice Address - Street 1:CARR. 112 KM 2.8
Practice Address - Street 2:BO. GUERRERO
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-932-2957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-03
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0549111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor