Active NPI
Hae S Larens
- Prosthetic/Orthotic Supplier
- Daytona Beach, FL
National Provider Identifier
1003371618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 74-8012445996-9
- Practice address
- 120 S Beach St
Daytona Beach, FL 32114-4402 - Phone
- (386) 258-8920
- NPI assigned
- Feb 7, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetic/Orthotic Supplier | 335E00000X | 74-8012445996-9 | FL | Primary |
Addresses
Primary practice location
120 S Beach St
Daytona Beach, FL 32114-4402
Mailing address
120 S Beach St
Daytona Beach, FL 32114-4402
Phone (386) 258-8920
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74-8012445996-9 | FL | MD | Prosthetic/Orthotic Supplier |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549497600000",
"number": "1003371618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 S BEACH ST",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321144402",
"telephone_number": "386-258-8920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 S BEACH ST",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321144402",
"telephone_number": "386-258-8920"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARENS",
"first_name": "HAE",
"middle_name": "S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-07",
"last_updated": "2019-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "335E00000X",
"taxonomy_group": "",
"desc": "Prosthetic/Orthotic Supplier",
"state": "FL",
"license": "74-8012445996-9",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.