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Jose Lazaga
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NPI Number Detailed Information
Provider Information:
Name: | Jose Lazaga |
Gender: | M |
Provider License Number If Given: | 2925 |
NPI Information:
NPI: | 1437158953 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 7/18/2005 |
Last Update Date: | 7/8/2007 |
Provider Business Mailing Address:
Address: | 300 AVE PINERO San Juan, PR 00918 |
Phone Number: | 7877589196 |
Fax Number: | 7877588280 |
Provider Business Practice Location Address:
Address: | 300 AVE PINERO San Juan, PR 00918 |
Phone Number: | 7877589196 |
Fax Number: | 7877588280 |
Provider Taxonomy:
Primary: | 174400000X |
Secondary (if any): | |
State: | PR |