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NPI Code Detail

MEDICARE: DANIELA LARA

MEDICARE: DANIELA LARA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1447989041
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELA LARA
Provider Business Mailing Address
First Line : 3195 GULFSTREAM RD
Second Line :
City : LAKE WORTH
State : FL
Zip : 33461-2405
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2677 FOREST HILL BLVD STE 109
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33406-5941
Country : US
Telephone Number : 561-294-9059
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2022
Last Update Date : 06/09/2022

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Directions to “ DANIELA LARA ” Practice Location

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