MEDICARE: DR. BRAZELIA LAZZARI

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	171100000X	Acupuncturist	AP2366	FL

General Provider Information

NPI Number	:	1962623314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRAZELIA LAZZARI

Provider Business Mailing Address
First Line	:	2561 NW 79TH AVE
Second Line	:
City	:	MARGATE
State	:	FL
Zip	:	33063-8156
Country	:	US
Telephone Number	:	954-214-1065
Fax Number	:	954-414-8422

Provider Business Practice Location Address
First Line	:	2717 E OAKLAND PARK BLVD
Second Line	:	SUITE 103
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33306-1664
Country	:	US
Telephone Number	:	954-566-5097
Fax Number	:	954-414-8422

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	07/08/2007

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