Provider Demographics
NPI:1013682988
Name:LAZARO ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:LAZARO ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:LIONEL
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:LAZARO COLLAZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-565-8562
Mailing Address - Street 1:300 AVE LA SIERRA
Mailing Address - Street 2:BOX 187 R-8
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-223-9160
Mailing Address - Fax:
Practice Address - Street 1:1665 AVE VCTR LABIOSA STE 106
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00926-4149
Practice Address - Country:US
Practice Address - Phone:787-223-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1679731657OtherINDIVIDUAL