Provider Demographics
NPI:1679300693
Name:RODRIGUEZ, LAZARO (APRN)
Entity type:Individual
Prefix:MR
First Name:LAZARO
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 BRICKELL BAY DR STE 2402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-4940
Mailing Address - Country:US
Mailing Address - Phone:305-992-4379
Mailing Address - Fax:
Practice Address - Street 1:1001 BRICKELL BAY DR STE 2402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-4940
Practice Address - Country:US
Practice Address - Phone:305-992-4379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-14
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035002363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily