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Organization
GULF COAST KIDNEY ASSOCIATES, PL
Active
Organization
GULF COAST KIDNEY ASSOCIATES, PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW L. LAZIN M.D. (STAFF PHYSICIAN)
(941) 917-8722
Entity
Organization
Contact information
Practice address
1921 WALDEMERE ST, SUITE 306, SARASOTA, FL 34239-2943
(941) 917-8722
(941) 917-8727
Mailing address
1921 WALDEMERE ST, SUITE 306, SARASOTA, FL 34239-2943
(941) 917-8722
(941) 917-8727
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254520001
—
FL
05
—
254542000
—
FL
01
—
38341
BCBS
FL
Enumeration date
04/19/2006
Last updated
05/24/2010
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