=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184920324
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL A LAZAR M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/06/2011
-----------------------------------------------------
Last Update Date | 03/30/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7600 W SUNRISE BLVD
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33322-4115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-939-5305
-----------------------------------------------------
Fax | 954-618-4347
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7600 W SUNRISE BLVD
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33322-4115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-939-5305
-----------------------------------------------------
Fax | 954-618-4347
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | 251450
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number | ME142291
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------