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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