Individual provider Active NPI

Marnie Dena Laratro, PSY.D.

  • Clinical Psychologist
  • Hollywood, FL
National Provider Identifier
1255560959
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY7894 Issued in FL
Practice address
1131 N 35TH Ave Ste 330
Hollywood, FL 33021-5403
Phone
(954) 265-3650
Fax
(954) 281-9996
NPI assigned
Jul 2, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY7894 FL Primary

Addresses

Primary practice location

1131 N 35TH Ave Ste 330
Hollywood, FL 33021-5403

Mailing address

2900 Corporate Way Ste D
Miramar, FL 33025-3925
Phone (954) 276-5603

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlaratro13877@MHSDIRECT.NET Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001551 FL Practitioner - Clinical Psychologist 1557487071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Broward Hospital DistrictGroup PAC ID 8123927373, 659 clinicians

Practice addresses (Care Compare)

1131 N 35TH Ave
Hollywood, FL 33021-5403

4651 Sheridan St
Suite 150
Hollywood, FL 33021-3443
Phone (954) 265-6331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Broward Hospital District CurrentSince Oct 27, 2019 Accepting new patients
South Broward Hospital District CurrentSince Oct 27, 2019 Accepting new patients

Locations

1131 N 35th Ave
Ste 330
Hollywood, FL 33021
Phone (954) 265-4475

2900 Corporate Way
Miramar, FL 33025
Phone (954) 276-5411

2900 Corporate Way
Ste D
Miramar, FL 33025
Phone (954) 276-5572

4651 Sheridan St
Ste 150
Pembroke Park, FL 33021
Phone (954) 265-6331

Interoperability endpoints

  • Direct secure messaging: mlaratro13877@mhsdirect.net

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1255560959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 CORPORATE WAY STE D",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330253925",
            "telephone_number": "954-276-5603",
            "fax_number": "954-985-7073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 N 35TH AVE STE 330",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330215403",
            "telephone_number": "954-265-3650",
            "fax_number": "954-281-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARATRO",
        "first_name": "MARNIE",
        "middle_name": "DENA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlaratro13877@MHSDIRECT.NET",
            "affiliation": "N",
            "endpointDescription": "MHS DSM",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1131 N 35th Ave Ste 330",
            "city": "Hollywood",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330215403",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.