Provider Demographics
NPI:1477871549
Name:LAZERSON, LEE H
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:H
Last Name:LAZERSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6231 NW 75TH WAY
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1250
Mailing Address - Country:US
Mailing Address - Phone:954-464-6134
Mailing Address - Fax:866-275-4496
Practice Address - Street 1:6231 NW 75TH WAY
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33067-1250
Practice Address - Country:US
Practice Address - Phone:954-464-6134
Practice Address - Fax:866-275-4496
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist