Organization
DAVID W LAZAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WALTER LAZAN M.D. (OWNER)
(772) 569-4464
Entity
Organization
Contact information
Practice address
1600 36TH STREET, SUITE B, VERO BEACH, FL 32960
(772) 569-4464
(772) 569-5656
Mailing address
1600 36TH STREET, SUITE B, VERO BEACH, FL 32960
(772) 569-4464
(772) 569-5656
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9647005
GHI
FL
01
—
DD8912
RAILROAD MEDICARE
FL
Enumeration date
07/28/2006
Last updated
12/22/2009
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