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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