Healthcare Provider Details

I. General information

NPI: 1144090291
Provider Name (Legal Business Name): DINA LAZARSKI MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8359 BEACON BLVD STE 416
FORT MYERS FL
33907-3065
US

IV. Provider business mailing address

11002 MILL CREEK WAY APT 1805
FORT MYERS FL
33913-6671
US

V. Phone/Fax

Practice location:
  • Phone: 800-920-1927
  • Fax:
Mailing address:
  • Phone: 224-733-3588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW27186
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: