Healthcare Provider Details

I. General information

NPI: 1962512285
Provider Name (Legal Business Name): LAZARO HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11401 SW 40TH ST STE 324
MIAMI FL
33165-3339
US

IV. Provider business mailing address

11401 SW 40TH ST STE 324
MIAMI FL
33165-3339
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-4017
  • Fax: 305-223-4018
Mailing address:
  • Phone: 305-223-4017
  • Fax: 305-223-4018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateFL

VIII. Authorized Official

Name: YOSVANY COLLERA
Title or Position: CEO
Credential: RN
Phone: 305-223-4017