Provider Demographics
NPI:1831323328
Name:NAZARIO LAZO, CYNTHIA (OD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:NAZARIO LAZO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ISABELA BEACH COURT 343
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00662
Mailing Address - Country:UM
Mailing Address - Phone:787-528-4369
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA # 2 BARRIO GALATEO BAJO KM109.9
Practice Address - Street 2:PLAZO BAZO # 3
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-2421
Practice Address - Country:US
Practice Address - Phone:787-830-4393
Practice Address - Fax:787-830-4393
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR549152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist