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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 |
