MEDICARE: ELVIS LAZARO FERRERA

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	170100000X	Ph.D. Medical Genetics	00000000000	FL

General Provider Information

NPI Number	:	1952506412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELVIS LAZARO FERRERA

Provider Business Mailing Address
First Line	:	351 W 34TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-4309
Country	:	US
Telephone Number	:	786-295-5738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1506 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-3159
Country	:	US
Telephone Number	:	786-507-0222
Fax Number	:

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

Provider Enumeration Date	:	06/15/2007
Last Update Date	:	07/08/2007

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Directions to “ ELVIS LAZARO FERRERA ” Practice Location

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