Individual provider Active NPI

Ciceron Lazo, MD

  • Family Medicine Physician
  • Jacksonville, FL
National Provider Identifier
1962567156
Registry record updated Jun 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME004648 Issued in FL
Practice address
8016 Atlantic Blvd
Jacksonville, FL 32211-8751
Phone
(904) 619-8687
NPI assigned
Dec 27, 2006
Last updated
Jun 3, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME004648 FL Primary

Addresses

Primary practice location

8016 Atlantic Blvd
Jacksonville, FL 32211-8751

Mailing address

8016 Atlantic Blvd
Jacksonville, FL 32211-8751
Phone (904) 619-8687

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000969 FL Practitioner - Family Practice 7517159312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Toledo College of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6028 Bennett Rd
Jacksonville, FL 32216-5004

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME004648FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Medical Associates LLC CurrentSince Nov 1, 2022 Accepting new patients

Locations

6028 Bennett Rd
Jacksonville, FL 32216
Phone (904) 703-4539

13940 N US Highway 441
Ste 102
Lady Lake, FL 32159
Phone (352) 509-9900

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

Interoperability endpoints

  • Direct secure messaging: ciceron.lazo@sl.eclinicaldirectplus.com

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780444800000",
    "number": "1962567156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8016 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118751",
            "telephone_number": "904-619-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8016 ATLANTIC BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118751",
            "telephone_number": "904-619-8687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZO",
        "first_name": "CICERON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-27",
        "last_updated": "2026-06-03",
        "certification_date": "2026-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME004648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.