Provider Demographics
NPI:1124369020
Name:LAZARO DIAZ-NUNEZ, MD
Entity Type:Organization
Organization Name:LAZARO DIAZ-NUNEZ, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP SUPPORT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-500-2108
Mailing Address - Street 1:7200 CORPORATE CENTER DR
Mailing Address - Street 2:600
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-1200
Mailing Address - Country:US
Mailing Address - Phone:305-500-2000
Mailing Address - Fax:305-500-2080
Practice Address - Street 1:3233 PALM AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5427
Practice Address - Country:US
Practice Address - Phone:305-557-1000
Practice Address - Fax:305-558-1212
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONTINUCARE MDHC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME108511332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site