Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Clarissa Vitalina Reynoso Azuris, MD

Individual provider Pediatrics Physician · NPI 1669877908

Clarissa Vitalina Reynoso Azuris, MD is a Pediatric Medicine in Baton Rouge, Louisiana. Qualified in 2008, 18 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Louisiana.

Years since qualifying
18
Licensed in
LA
In the registry since
2014
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

8415 Goodwood Blvd Ste 202
Baton Rouge, LA 70806-7851
Phone: (225) 765-8013
Fax: (225) 765-2033
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 113 Liner Dr, Greenwood, SC 29646-2311 — (864) 941-8170

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 334001 (LA)

Record details

NPI number1669877908
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 29, 2014
Last updated in NPPESMay 31, 2026
Certification dateMay 31, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Also practisesHOSPICE/PALLIATIVE CARE
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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