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:
Health care specialties
| Specialty | Code | License # | 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 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1821309618 | NPPES |
| Florida | MEDICAID | 017856800 |
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