=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982369195
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARA DELANEY LEZCANO PA-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2021
-----------------------------------------------------
Last Update Date | 10/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4205 W ATLANTIC AVE STE 201
-----------------------------------------------------
City | DELRAY BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33445-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-303-0013
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 MAYORCA CT
-----------------------------------------------------
City | ROYAL PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33411-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-779-0566
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------