Healthcare Provider Details

I. General information

NPI: 1912455189
Provider Name (Legal Business Name): LAZARO SANCHEZ OLAZABAL NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 W 20TH AVE STE 101
HIALEAH FL
33016-1813
US

IV. Provider business mailing address

5077 NW 7TH ST PH 18
MIAMI FL
33126-3685
US

V. Phone/Fax

Practice location:
  • Phone: 305-822-0401
  • Fax: 305-824-1748
Mailing address:
  • Phone: 786-757-5034
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11014168
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: