Provider Demographics
NPI:1831706803
Name:LAZO, IRIS JEANNETTE
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:JEANNETTE
Last Name:LAZO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 WILLA SPRINGS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5205
Mailing Address - Country:US
Mailing Address - Phone:407-637-5891
Mailing Address - Fax:407-636-6205
Practice Address - Street 1:1008 WILLA SPRINGS DR STE 110
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5205
Practice Address - Country:US
Practice Address - Phone:407-637-5891
Practice Address - Fax:407-636-6205
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist