Individual provider Active NPI

Daniel Carlos Lazo, DPT

  • Physical Therapist
  • Pembroke Pines, FL
National Provider Identifier
1225414899
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30629 Issued in FL
Practice address
17796 SW 2ND St
Pembroke Pines, FL 33029-3923
Phone
(954) 438-7800
NPI assigned
Aug 6, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X 30629 FL Primary

Addresses

Primary practice location

17796 SW 2ND St
Pembroke Pines, FL 33029-3923

Mailing address

807 NW 133Rd CT
Miami, FL 33182-2201
Phone (305) 310-7357

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190528000666 FL Practitioner - Physical Therapist in Private Practice 7214270636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physio2Restore CorpGroup PAC ID 5890172779, 2 clinicians

Practice addresses (Care Compare)

11430 N Kendall Dr
Suite 110
Miami, FL 33176-1041
Phone (786) 675-6801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30629FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physio2Restore, Corp. Physical Therapist CurrentSince Apr 1, 2025 Accepting new patients

Locations

11430 N Kendall Dr
Ste 110
Miami, FL 33176
Phone (786) 541-7848

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1225414899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 NW 133RD CT",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331822201",
            "telephone_number": "305-310-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17796 SW 2ND ST",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330293923",
            "telephone_number": "954-438-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZO",
        "first_name": "DANIEL",
        "middle_name": "CARLOS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "30629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.