Healthcare Provider Details

I. General information

NPI: 1417578048
Provider Name (Legal Business Name): LARA GUINDI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MEMORIAL MEDICAL PKWY STE 307
DAYTONA BEACH FL
32117-5167
US

IV. Provider business mailing address

305 MEMORIAL MEDICAL PKWY STE 307
DAYTONA BEACH FL
32117-5169
US

V. Phone/Fax

Practice location:
  • Phone: 386-231-4315
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberME182342
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: