Provider Demographics
NPI:1235109919
Name:LAZARTE, ROBERT PASCUAL (MSN)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:PASCUAL
Last Name:LAZARTE
Suffix:
Gender:M
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1989 CLOISTER CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-6640
Mailing Address - Country:US
Mailing Address - Phone:904-215-7627
Mailing Address - Fax:
Practice Address - Street 1:1989 CLOISTER CT
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-6640
Practice Address - Country:US
Practice Address - Phone:904-215-7627
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1847642363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily