Provider Demographics
NPI:1003674573
Name:MACHADO SANCHEZ, LAZARO ANTONIO
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:ANTONIO
Last Name:MACHADO SANCHEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 HILL DR APT D
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-3776
Mailing Address - Country:US
Mailing Address - Phone:786-399-9230
Mailing Address - Fax:
Practice Address - Street 1:850 HILL DR APT D
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-3776
Practice Address - Country:US
Practice Address - Phone:786-399-9230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11031713363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner