Provider Demographics
NPI:1598792707
Name:GARCIA, LAZARO MIGUEL (MD)
Entity Type:Individual
Prefix:MR
First Name:LAZARO
Middle Name:MIGUEL
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3626 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-4069
Mailing Address - Country:US
Mailing Address - Phone:305-643-4343
Mailing Address - Fax:305-643-3488
Practice Address - Street 1:3626 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4069
Practice Address - Country:US
Practice Address - Phone:305-643-4343
Practice Address - Fax:305-643-3488
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0067163207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL116967OtherAMERIGROUP OF FL
FL376490700Medicaid
FLD00561OtherDOCTOR CARE INC
FL26171OtherBLUE CROSS BLUE SHIELD
FL23305OtherNEIGHBORHOOD
FLF90766Medicare UPIN
FL376490700Medicaid