Organization Active NPI

Lara Cortes Aprn LLC

Doing business as BayouSide Health & Wellness

  • Gerontology Nurse Practitioner
  • Tarpon Springs, FL
National Provider Identifier
1407641756
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
Legal business name
LARA CORTES APRN LLC
Doing business as
BayouSide Health & Wellness
Practice address
520 E Tarpon Ave
Tarpon Springs, FL 34689-4324
Phone
(727) 935-1185
Fax
(727) 935-1183
NPI assigned
Apr 9, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Authorized official

Name
Lara Cortes, APRNNPI 1790254639
Title
Practice Owner
Phone
(727) 935-1185

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X Primary

Addresses

Primary practice location

520 E Tarpon Ave
Tarpon Springs, FL 34689-4324

Mailing address

520 E Tarpon Ave
Tarpon Springs, FL 34689-4324
Phone (727) 935-1185

Other names 1

  • BayouSide Health & Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250715000164 FL Part B Supplier - Clinic/Group Practice 0547775991 Receives reassigned benefits from 1 practitioner
Practice locations: Tarpon Springs, FL

National Provider Directory

National Provider Directory

Locations

520 E Tarpon Ave
Tarpon Springs, FL 34689
Phone (727) 935-1185

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1744156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1407641756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E TARPON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346894324",
            "telephone_number": "727-935-1185",
            "fax_number": "727-935-1183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 E TARPON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346894324",
            "telephone_number": "727-935-1185",
            "fax_number": "727-935-1183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARA CORTES APRN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-09",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "CORTES",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "727-935-1185",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BayouSide Health & Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.