Provider Demographics
NPI:1962623314
Name:LAZZARI, BRAZELIA
Entity type:Individual
Prefix:DR
First Name:BRAZELIA
Middle Name:
Last Name:LAZZARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2561 NW 79TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-8156
Mailing Address - Country:US
Mailing Address - Phone:954-214-1065
Mailing Address - Fax:954-414-8422
Practice Address - Street 1:2717 E OAKLAND PARK BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1664
Practice Address - Country:US
Practice Address - Phone:954-566-5097
Practice Address - Fax:954-414-8422
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2366171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist