Nicolas, Lara

Nicolas, Lara is an sole proprietor health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Nicolas, Lara can be contacted via phone (352) 265-0462.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-3001
Phone: (352) 265-0462
Fax: (352) 265-0443
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 125.057377 Illinois
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X ME127080 Florida

Profile Details

NPI number 1821309618
LBN Legal business name Nicolas, Lara
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 25th, 2010
Last updated Sep 9th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821309618 NPPES
Florida MEDICAID 017856800

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