MEDICARE: LAZAR B SULIMANOV

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	332B00000X	Durable Medical Equipment & Medical Supplies		AZ

General Provider Information

NPI Number	:	1821312299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAZAR B SULIMANOV

Provider Business Mailing Address
First Line	:	4015 E BELL RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2243
Country	:	US
Telephone Number	:	602-910-7545
Fax Number	:

Provider Business Practice Location Address
First Line	:	4015 E BELL RD
Second Line	:	SUITE 130
City	:	PHOENIX
State	:	AZ
Zip	:	85032-2243
Country	:	US
Telephone Number	:	602-910-7545
Fax Number	:

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

Provider Enumeration Date	:	03/15/2010
Last Update Date	:	08/30/2011

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Directions to “ LAZAR B SULIMANOV ” Practice Location

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