Wittine, Lara M

Wittine, Lara M is an individual health care provider with primary practice located at 3000 Medical Park Dr Ste 510 , Tampa FL 33613-6602. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sleep Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Sleep Medicine is her primary health care specialty. Wittine, Lara M can be contacted via phone (813) 615-7725.

Contact Information

Primary practice address
3000 Medical Park Dr Ste 510 Tampa FL 33613-6602
Phone: (813) 615-7725
Fax: (813) 615-7082
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X ME125433 Florida
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X ME125433 Florida

Profile Details

NPI number 1245307941
LBN Legal business name Wittine, Lara M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Mar 18th, 2024 - about 2 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 1245307941 NPPES
Florida Other PJWDL BLUE CROSS BLUE SHIELD
Florida MEDICAID 018286300 BLUE CROSS BLUE SHIELD

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