Provider Demographics
NPI:1346844057
Name:LAZOS DE AMOR LLC
Entity Type:Organization
Organization Name:LAZOS DE AMOR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:LISANKYS
Authorized Official - Middle Name:
Authorized Official - Last Name:LAZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-970-6345
Mailing Address - Street 1:17810 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-6400
Mailing Address - Country:US
Mailing Address - Phone:786-227-6963
Mailing Address - Fax:786-227-6963
Practice Address - Street 1:17810 SW 137TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-6400
Practice Address - Country:US
Practice Address - Phone:786-227-6963
Practice Address - Fax:786-227-6963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility