Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 95622 | FL |
NPI | 1053352583 |
---|---|
Provider Name | Eric Sean Lazar |
First Address | Boca Raton, FL 33496-2658 |
Second Address | Boca Raton, FL 33496-2658 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |