Provider Demographics
NPI:1548223589
Name:LAZARO, PAULO GUSTAVO (LCSW, CBT)
Entity Type:Individual
Prefix:MR
First Name:PAULO
Middle Name:GUSTAVO
Last Name:LAZARO
Suffix:
Gender:M
Credentials:LCSW, CBT
Other - Prefix:MR
Other - First Name:PAULO
Other - Middle Name:
Other - Last Name:FIGUEIREDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, CBT
Mailing Address - Street 1:13499 BISCAYNE BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2059
Mailing Address - Country:US
Mailing Address - Phone:305-206-2899
Mailing Address - Fax:954-510-2079
Practice Address - Street 1:13499 BISCAYNE BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2059
Practice Address - Country:US
Practice Address - Phone:305-206-2899
Practice Address - Fax:954-510-2079
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW52581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ9778ZOtherMEDICARE ID- TYPE UNSPECIFIED