Provider Demographics
NPI:1992917033
Name:ALAN M LAZAR MD PA
Entity type:Organization
Organization Name:ALAN M LAZAR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:LAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-476-9494
Mailing Address - Street 1:PO BOX 16957
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33318-6957
Mailing Address - Country:US
Mailing Address - Phone:954-476-9494
Mailing Address - Fax:954-473-9460
Practice Address - Street 1:350 NW 84TH AVE
Practice Address - Street 2:STE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-1817
Practice Address - Country:US
Practice Address - Phone:954-476-9494
Practice Address - Fax:954-473-9460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD63025Medicare UPIN
FL0373850001Medicare NSC
FL93821VMedicare PIN