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General NPI Number Information
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NPI Number | 1194240036
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Entity Type | Individual
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Provider Name | LAZARA ROSA JARDINES PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2017
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 1423 SW 161ST AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-5139
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Country | US
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Telephone | 786-402-2423
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Fax |
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Provider Business Mailing Address
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Address Line | 4480 SW 153RD AVE
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City | MIRAMAR
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State | FL
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Zip | 33027-3373
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Country | US
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Telephone | 786-402-2423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS42804
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License Number State | FL
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