Provider Demographics
NPI:1174682090
Name:NUNEZ, LAZARO D (MD)
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:D
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 NW 119TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33167-3232
Mailing Address - Country:US
Mailing Address - Phone:305-685-5688
Mailing Address - Fax:305-688-7995
Practice Address - Street 1:5521 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2219
Practice Address - Country:US
Practice Address - Phone:305-685-5688
Practice Address - Fax:305-626-7967
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME78781208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME78781OtherME LICENSE
FL330005600Medicaid
FL330005600Medicaid
FLME78781OtherME LICENSE
FLE3296 AMedicare PIN