Provider Demographics
NPI:1578569596
Name:LAZAR, LAWRENCE G (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:G
Last Name:LAZAR
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 19TH ST NW
Mailing Address - Street 2:STE 409
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3701
Mailing Address - Country:US
Mailing Address - Phone:202-223-0500
Mailing Address - Fax:
Practice Address - Street 1:12085 W HILLSBOROUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33635-9725
Practice Address - Country:US
Practice Address - Phone:813-397-5300
Practice Address - Fax:813-738-9007
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3786213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPO3786OtherMEDICAL LICENSE
MDP00195982OtherRAILROAD MEDICARE
DC021254600Medicaid
DC021254600Medicaid
MD713800800Medicaid