Healthcare Provider Details

I. General information

NPI: 1770567059
Provider Name (Legal Business Name): ROSSITZA Z LAZOVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9060 E VIA LINDA STE 150
SCOTTSDALE AZ
85258-5424
US

IV. Provider business mailing address

1355 RIVER BEND DR
DALLAS TX
75247-4915
US

V. Phone/Fax

Practice location:
  • Phone: 480-275-2494
  • Fax: 408-558-7949
Mailing address:
  • Phone: 214-237-1818
  • Fax: 844-751-9263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number68127
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: