MEDICARE: DR. LIONEL E. LAZARO M.D.

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	207X00000X	Orthopaedic Surgery Physician	ME141332	FL
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	A155569	CA
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	22185	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679731657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LIONEL E. LAZARO M.D.

Provider Business Mailing Address
First Line	:	300 AVE LA SIERRA
Second Line	:	BOX 187 R-8
City	:	SAN JUAN
State	:	PR
Zip	:	00926
Country	:	US
Telephone Number	:	787-223-9160
Fax Number	:

Provider Business Practice Location Address
First Line	:	1665 AVE VICTOR M LABIOSA STE 106
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-4149
Country	:	US
Telephone Number	:	787-223-9160
Fax Number	:

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

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	06/06/2022

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Directions to “ DR. LIONEL E. LAZARO M.D.” Practice Location

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