Healthcare Provider Details

I. General information

NPI: 1184920324
Provider Name (Legal Business Name): DANIEL A LAZAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2011
Last Update Date: 03/30/2021
Certification Date: 03/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 W SUNRISE BLVD
PLANTATION FL
33322-4115
US

IV. Provider business mailing address

7600 W SUNRISE BLVD
PLANTATION FL
33322-4115
US

V. Phone/Fax

Practice location:
  • Phone: 954-939-5305
  • Fax: 954-618-4347
Mailing address:
  • Phone: 954-939-5305
  • Fax: 954-618-4347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number251450
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME142291
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: