Provider Demographics
NPI:1568101632
Name:RODRIGUEZ-NENINGER, LAZARO H
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:H
Last Name:RODRIGUEZ-NENINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LAZARO
Other - Middle Name:
Other - Last Name:RODRIGUEZ-NENINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DIPLOM NCCAOM CERT
Mailing Address - Street 1:8306 MILLS DR STE 688
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4838
Mailing Address - Country:US
Mailing Address - Phone:786-516-5065
Mailing Address - Fax:
Practice Address - Street 1:10641 SW 108TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176
Practice Address - Country:US
Practice Address - Phone:786-516-5065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02918171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist