Provider Demographics
NPI:1689826224
Name:LAZARIN, FRANCISCO ROBERTO JR
Entity Type:Individual
Prefix:
First Name:FRANCISCO
Middle Name:ROBERTO
Last Name:LAZARIN
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-990 HANAUNA ST # 13B
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4742
Mailing Address - Country:US
Mailing Address - Phone:808-471-5114
Mailing Address - Fax:
Practice Address - Street 1:USS FRD
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96665-1508
Practice Address - Country:US
Practice Address - Phone:808-471-5114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman