Provider Demographics
NPI:1164448718
Name:JONAS-LAZIN, SHERRI A (MD)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:A
Last Name:JONAS-LAZIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7313 INTERNATIONAL PL
Mailing Address - Street 2:SUITE 80
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34240
Mailing Address - Country:US
Mailing Address - Phone:941-907-1190
Mailing Address - Fax:941-907-0305
Practice Address - Street 1:6320 VENTURE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-5130
Practice Address - Country:US
Practice Address - Phone:941-924-9955
Practice Address - Fax:941-924-5616
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME59445207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME59445OtherLICENSE NUMBER
FLP00376714OtherRAILROAD MEDICARE
FL12318WMedicare PIN