MEDICARE: MARCI LAZAR PT

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	225100000X	Physical Therapist	PT17198	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952883373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCI LAZAR PT

Provider Business Mailing Address
First Line	:	9153 PICOT CT
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33472-2468
Country	:	US
Telephone Number	:	561-523-4756
Fax Number	:

Provider Business Practice Location Address
First Line	:	401 E LINTON BLVD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33483-5028
Country	:	US
Telephone Number	:	561-526-0185
Fax Number	:

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

Provider Enumeration Date	:	08/31/2018
Last Update Date	:	08/31/2018

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Directions to “ MARCI LAZAR PT” Practice Location

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