Provider Demographics
NPI:1932144391
Name:LAMAZARES, FERNANDO LUIS (LMT)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:LUIS
Last Name:LAMAZARES
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11022 SW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-1314
Mailing Address - Country:US
Mailing Address - Phone:305-559-5624
Mailing Address - Fax:
Practice Address - Street 1:7203 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4653
Practice Address - Country:US
Practice Address - Phone:305-265-1040
Practice Address - Fax:305-265-1046
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 11319247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other