Healthcare Provider Details

I. General information

NPI: 1942096334
Provider Name (Legal Business Name): DR. MARIA INES LAZARO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2025
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VILLA KENNEDY
SAN JUAN PR
00915-2729
US

IV. Provider business mailing address

PO BOX 71114
SAN JUAN PR
00936-8014
US

V. Phone/Fax

Practice location:
  • Phone: 787-675-6858
  • Fax:
Mailing address:
  • Phone: 787-675-6858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number4316
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: