Provider Demographics
NPI:1821496068
Name:GARRIDO, LAZARO JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:LAZARO
Middle Name:JOSEPH
Last Name:GARRIDO
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 1:14612 SW 143RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-7204
Mailing Address - Country:US
Mailing Address - Phone:786-387-2597
Mailing Address - Fax:
Practice Address - Street 1:2331 N STATE ROAD 7 STE 220
Practice Address - Street 2:
Practice Address - City:LAUDERDALE LAKES
Practice Address - State:FL
Practice Address - Zip Code:33313-3772
Practice Address - Country:US
Practice Address - Phone:786-387-2597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN1295208D00000X, 208D00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108162200Medicaid