Organization
LAZZARA DERMATOLOGY & MOHS SURGERY OF MILTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIELLE RAFFAELLA LAZZARA DO (CHIEF MEDICAL OFFICER)
(732) 977-8371
Entity
Organization
Contact information
Practice address
12455 BROADWELL RD STE 102-103, MILTON, GA 30004-6315
(770) 375-6197
(770) 215-7577
Mailing address
12455 BROADWELL RD STE 102-103, MILTON, GA 30004-6315
(770) 375-6197
(770) 215-7577
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
05/18/2024
Last updated
01/28/2025
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