Provider Demographics
NPI:1053854315
Name:GAFAS, LAZARO LUIS (APRN, FNP-C,PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:LUIS
Last Name:GAFAS
Suffix:
Gender:M
Credentials:APRN, FNP-C,PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 NW 53RD ST STE 337
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4791
Mailing Address - Country:US
Mailing Address - Phone:786-529-6651
Mailing Address - Fax:612-500-4880
Practice Address - Street 1:7950 NW 53RD ST STE 337
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-4791
Practice Address - Country:US
Practice Address - Phone:786-529-6651
Practice Address - Fax:612-500-4880
Is Sole Proprietor?:No
Enumeration Date:2016-11-18
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9325283363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117193800Medicaid