1558821025 NPI number — DR. CARLOS ALBERTO LAZU ARROYO MBA, MD

Table of content: DR. CARLOS ALBERTO LAZU ARROYO MBA, MD (NPI 1558821025)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558821025 NPI number — DR. CARLOS ALBERTO LAZU ARROYO MBA, MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAZU ARROYO
Provider First Name:
CARLOS
Provider Middle Name:
ALBERTO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MBA, MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAZU ARROYO
Provider Other First Name:
CARLOS
Provider Other Middle Name:
ALBERTO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1558821025
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URB MENDEZ A5
Provider Second Line Business Mailing Address:
CALLE MARGINAL
Provider Business Mailing Address City Name:
YABUCOA, PR
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00767
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
939-367-2000
Provider Business Mailing Address Fax Number:
787-852-0157

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RYDER MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
#355 CALLE FONT MARTELO
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
939-367-2000
Provider Business Practice Location Address Fax Number:
787-852-0157
Provider Enumeration Date:
03/21/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  22145 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 22145 . This is a "STATE LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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