Provider Demographics
NPI:1235814310
Name:GARCIA RODRIGUEZ, LAZARO (FNP)
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:
Last Name:GARCIA RODRIGUEZ
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7375 W 3RD CT APT 405
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-5049
Mailing Address - Country:US
Mailing Address - Phone:786-630-5901
Mailing Address - Fax:
Practice Address - Street 1:7375 W 3RD CT APT 405
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-5049
Practice Address - Country:US
Practice Address - Phone:786-630-5901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026033363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily