Healthcare Provider Details

I. General information

NPI: 1972015576
Provider Name (Legal Business Name): LAZARA DE LOURDES HURTADO INFANTE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2017
Last Update Date: 08/05/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 VETERANS PARK DR
NAPLES FL
34109-0493
US

IV. Provider business mailing address

1454 MADISON AVE W
IMMOKALEE FL
34142-2200
US

V. Phone/Fax

Practice location:
  • Phone: 239-658-3000
  • Fax:
Mailing address:
  • Phone: 239-658-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number9390565
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP9390565
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: