Organization
JCL ORAL SURGERY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUAN CARLOS LAZO DMD (PRESIDENT)
(305) 279-8600
Entity
Organization
Contact information
Practice address
11020 SW 88TH ST STE 106, MIAMI, FL 33176-1217
(305) 279-8600
Mailing address
11020 SW 88TH ST STE 106, MIAMI, FL 33176-1217
(305) 279-8600
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053705624
1053705624
FL
Enumeration date
11/15/2022
Last updated
11/15/2022
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