Healthcare Provider Details

I. General information

NPI: 1861691941
Provider Name (Legal Business Name): LOUIS LAZO RRT-NPS, RPFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 W 49TH ST SUITE #717
HIALEAH FL
33012-2942
US

IV. Provider business mailing address

15641 SW 144TH PL
MIAMI FL
33177-6811
US

V. Phone/Fax

Practice location:
  • Phone: 305-251-2377
  • Fax: 305-995-2699
Mailing address:
  • Phone: 305-251-2377
  • Fax: 305-995-2699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License NumberRT 917
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2279H0200X
TaxonomyHome Health Registered Respiratory Therapist
License NumberRT 917
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: