Provider Demographics
NPI:1306408182
Name:LAMAZARES, MARIA ELENA (DMD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:LAMAZARES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6411 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33634-1140
Mailing Address - Country:US
Mailing Address - Phone:813-886-7000
Mailing Address - Fax:
Practice Address - Street 1:6411 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-1140
Practice Address - Country:US
Practice Address - Phone:813-735-2038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24409122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist