Active NPI
Jacob Lazarovic, M.D.
- Family Medicine Physician
- Sunrise, FL
National Provider Identifier
1457697914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME 36489
- Practice address
- 1391 NW 136TH Ave
Sunrise, FL 33323-2800 - Phone
- (954) 693-1774
- NPI assigned
- Jan 2, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME 36489 | FL | Primary |
Addresses
Primary practice location
1391 NW 136TH Ave
Sunrise, FL 33323-2800
Mailing address
1391 NW 136TH Ave
Sunrise, FL 33323-2800
Phone (954) 693-1774
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 36489 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357084800000",
"number": "1457697914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1391 NW 136TH AVE",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232800",
"telephone_number": "954-693-1774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1391 NW 136TH AVE",
"city": "SUNRISE",
"state": "FL",
"postal_code": "333232800",
"telephone_number": "954-693-1774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAZAROVIC",
"first_name": "JACOB",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-01-02",
"last_updated": "2013-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME 36489",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunrise, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.