Provider Demographics
NPI:1770147456
Name:LAUZURIQUE FIOL, ROBERTO OSMANI (APRN)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:OSMANI
Last Name:LAUZURIQUE FIOL
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6481 W 11TH CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6433
Mailing Address - Country:US
Mailing Address - Phone:786-523-8424
Mailing Address - Fax:
Practice Address - Street 1:1404 NW 22ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-7742
Practice Address - Country:US
Practice Address - Phone:305-325-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-28
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11002043363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily