LAZARO BOUZA MD PA
Osteopathic Medicine at 107 Ave, Miami, FL

License number
Florida ME0042893
Category
Osteopathic Medicine
Type
Gastroenterology
Owner
Name: LAZARO BOUZA M.D.
Title: MEDICAL DOCTOR/PRESIDENT
Phone: (305) 226-4634
Address
Address
3611 SW 107Th Ave, Miami, FL 33165
National Provider ID: 1023323086
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAZARO BOUZA, MD., PA

Miami, FL

Industry:
Medical Doctor's Office
Registration:
Aug 13, 1987
Addresses:
4370 SW 160 Ave, Miami, FL 33185 (Physical)
4370 S W 160 Ave, Miami, FL 33185 (Mailing)
3611 SW 107 Ave, Miami, FL 33165
State ID:
M57298
Business type:
Florida Profit Corporation
President, Secretarys:
Bouza, Lazaro Md Pa (Director), 4370 SW 160 Ave, Miami, FL 33185 (Physical),Lazaro Bouza President, Secretary, inactive
EIN:
592845629

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