Healthcare Provider Details

I. General information

NPI: 1285618595
Provider Name (Legal Business Name): VALERIE ANNE LAZZELL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/30/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2173A CENTERVILLE PL ANESTHESIOLOGY ASSOCIATES OF TALLAHASSEE
TALLAHASSEE FL
32308-4356
US

IV. Provider business mailing address

PO BOX 452198
SUNRISE FL
33345-2198
US

V. Phone/Fax

Practice location:
  • Phone: 850-385-0144
  • Fax: 850-385-0146
Mailing address:
  • Phone: 954-838-2371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberME64805
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: