Healthcare Provider Details

I. General information

NPI: 1174682090
Provider Name (Legal Business Name): LAZARO D NUNEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5521 SW 8TH ST
CORAL GABLES FL
33134-2219
US

IV. Provider business mailing address

1240 NW 119TH ST
MIAMI FL
33167-3232
US

V. Phone/Fax

Practice location:
  • Phone: 305-685-5688
  • Fax: 305-626-7967
Mailing address:
  • Phone: 305-685-5688
  • Fax: 305-688-7995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME78781
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: