MEDICARE: ADRIANA LAZARO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist
2	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1356863575
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA LAZARO

Provider Business Mailing Address
First Line	:	1410 ILLINOIS ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4130
Country	:	US
Telephone Number	:	813-900-8458
Fax Number	:

Provider Business Practice Location Address
First Line	:	1410 ILLINOIS ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803-4130
Country	:	US
Telephone Number	:	813-900-8458
Fax Number	:	813-900-8458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2017
Last Update Date	:	07/21/2022

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Directions to “ ADRIANA LAZARO ” Practice Location

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