Provider Demographics
NPI:1578635876
Name:HORACIO G. LARDO, MD, PC
Entity Type:Organization
Organization Name:HORACIO G. LARDO, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HORACIO
Authorized Official - Middle Name:G
Authorized Official - Last Name:LARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-335-4978
Mailing Address - Street 1:2827 HUNTERS BLF
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1828
Mailing Address - Country:US
Mailing Address - Phone:248-335-4978
Mailing Address - Fax:
Practice Address - Street 1:2827 HUNTERS BLF
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-1828
Practice Address - Country:US
Practice Address - Phone:248-335-4978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICI7308Medicare ID - Type UnspecifiedRAILROAD
MI0M43340Medicare ID - Type UnspecifiedPHYSICIAN
MI0P03140Medicare ID - Type UnspecifiedCRNA