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General NPI Number Information
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NPI Number | 1972715712
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Entity Type | Individual
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Provider Name | LAZARO C FERNANDEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8180 N.W. 155 STREET SUITE 200
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City | MIAMI LAKES
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State | FL
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Zip | 33016
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Country | US
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Telephone | 305-512-9250
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Fax | 305-512-9257
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Provider Business Mailing Address
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Address Line | 8180 N.W. 155 STREET SUITE 200
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City | MIAMI LAKES
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State | FL
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Zip | 33016
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Country | US
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Telephone | 305-512-9250
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Fax | 305-512-9257
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN-0014160
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License Number State | FL
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