Provider Demographics
NPI:1730142860
Name:LAZAR, ALAN M (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:LAZAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 NW 84TH AVENUE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324
Mailing Address - Country:US
Mailing Address - Phone:954-476-9494
Mailing Address - Fax:954-473-9460
Practice Address - Street 1:350 NW 84TH AVENUE
Practice Address - Street 2:SUITE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324
Practice Address - Country:US
Practice Address - Phone:954-476-9494
Practice Address - Fax:954-473-9460
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-10
Last Update Date:2009-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME34661207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL246078OtherAVMED
FL372571600OtherOWCP DEPT OF LABOR
FL4509321OtherAETNA
FL60864OtherNEIGHBORHOOD HEALTH
FL93821VOtherBCBS OF FLORIDA
FL0373850001Medicare NSC
FL93821VMedicare PIN
FL4509321OtherAETNA
FL93821VOtherBCBS OF FLORIDA
D63025Medicare UPIN