MEDICARE: LAZARO MIGUEL ENRIQUEZ CRNA

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	367500000X	Certified Registered Nurse Anesthetist	APRN11012381	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN9388101	OTHER	FL	RN LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659976306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAZARO MIGUEL ENRIQUEZ CRNA

Provider Business Mailing Address
First Line	:	13100 SW 280TH ST
Second Line	:
City	:	HOMESTEAD
State	:	FL
Zip	:	33032-8573
Country	:	US
Telephone Number	:	786-554-2109
Fax Number	:

Provider Business Practice Location Address
First Line	:	11750 SW 40TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33175-3530
Country	:	US
Telephone Number	:	305-223-3000
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	01/05/2026

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