Individual
MARCELA A LAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4671 S CONGRESS AVE, SUITE 100B, LAKE WORTH, FL 33461-4783
(561) 434-0111
(561) 296-3533
Mailing address
PO BOX 25317, TAMPA, FL 33622-5317
(813) 286-0033
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
ME110131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004197300
—
FL
01
—
14FW0
BCBS
—
01
—
LN461
MEDICARE
FL
Enumeration date
08/28/2007
Last updated
09/18/2019
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