MEDICARE: LILIETH LAZO ROMERO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1023828639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIETH LAZO ROMERO

Provider Business Mailing Address
First Line	:	777 NW 72ND AVE STE 1083
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33126-3176
Country	:	US
Telephone Number	:	786-490-6307
Fax Number	:

Provider Business Practice Location Address
First Line	:	2116 NW 24TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-7240
Country	:	US
Telephone Number	:	786-953-9756
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	01/08/2025

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Directions to “ LILIETH LAZO ROMERO ” Practice Location

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