Provider Demographics
NPI:1679731657
Name:LAZARO, LIONEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:LIONEL
Middle Name:E
Last Name:LAZARO
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 1:300 AVE LA SIERRA
Mailing Address - Street 2:BOX 187 R-8
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-223-9160
Mailing Address - Fax:
Practice Address - Street 1:1665 AVE VICTOR M LABIOSA STE 106
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4149
Practice Address - Country:US
Practice Address - Phone:787-223-9160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME141332207X00000X
CAA155569207XX0005X
PR22185207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery