Healthcare Provider Details

I. General information

NPI: 1811203946
Provider Name (Legal Business Name): LAZARO MIGUEL GARCIA, M.D.,P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 NW 7TH ST
MIAMI FL
33125-4069
US

IV. Provider business mailing address

3626 NW 7TH ST
MIAMI FL
33125-4069
US

V. Phone/Fax

Practice location:
  • Phone: 305-643-4343
  • Fax:
Mailing address:
  • Phone: 305-643-4343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME67163
License Number StateFL

VIII. Authorized Official

Name: DR. LAZARO MIGUEL GARCIA
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 305-643-4343