Provider Demographics
NPI:1518579606
Name:RAMIREZ ARTEAGA, LAZARO JESUS
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:JESUS
Last Name:RAMIREZ ARTEAGA
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 1:10713 SW 239TH TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6159
Mailing Address - Country:US
Mailing Address - Phone:786-973-9572
Mailing Address - Fax:
Practice Address - Street 1:3525 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4015
Practice Address - Country:US
Practice Address - Phone:786-801-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine