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General NPI Number Information
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NPI Number | 1548270556
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Entity Type | Individual
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Provider Name | NANCY MARLENE LAZARO M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 2330 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33406-7608
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Country | US
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Telephone | 561-432-5849
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Fax | 561-283-0677
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Provider Business Mailing Address
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Address Line | 2330 S CONGRESS AVE
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City | PALM SPRINGS
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State | FL
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Zip | 33406-7608
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Country | US
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Telephone | 561-432-5849
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Fax | 561-283-0677
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 14703
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ACN714
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License Number State | FL
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