Provider Demographics
NPI:1295357168
Name:NEMER LANIER, ALFREDO LAZARO (SA-C)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:LAZARO
Last Name:NEMER LANIER
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3478 W 97TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2026
Mailing Address - Country:US
Mailing Address - Phone:954-681-7646
Mailing Address - Fax:
Practice Address - Street 1:3478 W 97TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-2026
Practice Address - Country:US
Practice Address - Phone:954-681-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-203246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant