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NPI Code Detail

MEDICARE: LAZARO JESUS VALDES

MEDICARE:   LAZARO JESUS VALDES
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
1225700000XMassage TherapistMA59521FL

General Provider Information

NPI Number : 1720396047
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAZARO JESUS VALDES
Provider Business Mailing Address
First Line : 203 FOXTAIL DR APT B3
Second Line :
City : GREENACRES
State : FL
Zip : 33415-6001
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4935 OKEECHOBEE BLVD
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33417-4629
Country : US
Telephone Number : 561-682-9383
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2010
Last Update Date : 09/21/2010

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Directions to “ LAZARO JESUS VALDES ” Practice Location

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