Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 25MA10326800 | NJ |
N | 111NI0900X | Internist | 25MA10326800 | NJ |
Y | 207RI0200X | Infectious Disease | 28061 | FL |
NPI | 1023490935 |
---|---|
Provider Name | Dr. Alex F Lazo Vasquez |
First Address | Boston, MA 02241-6457 |
Second Address | Miami, FL 33136-1005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2015 |
Last Update Date | 01/10/2019 |