NPI 1023869435

Lazaro Guillermo Miranda Alfonso

Practitioner Driver Jacksonville, FL

Practice location

Address: 5332 Santa Monica Blvd N, Jacksonville, FL 32207-7435
Phone: (305) 849-5208

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X

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Registry record

NPI: 1023869435
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Apr 2024
Record last updated: 1 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.