Provider Demographics
NPI:1013225952
Name:LAZARO H CORDOVES MD PA
Entity Type:Organization
Organization Name:LAZARO H CORDOVES MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:H
Authorized Official - Last Name:CORDOVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-557-1030
Mailing Address - Street 1:5951 NW 173RD DR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5112
Mailing Address - Country:US
Mailing Address - Phone:305-557-1030
Mailing Address - Fax:305-557-9757
Practice Address - Street 1:5951 NW 173RD DR
Practice Address - Street 2:SUITE 7
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-5112
Practice Address - Country:US
Practice Address - Phone:305-557-1030
Practice Address - Fax:305-557-9757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME848532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty