Active NPI
Lara Michaela Vance, PTA
- Physical Therapy Assistant
- Lutz, FL
National Provider Identifier
1609751338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA30231
- Practice address
- 21760 FL-54 #102
Lutz, FL 33549 - Phone
- (813) 252-0561
- NPI assigned
- Aug 11, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA30231 | FL | Primary |
Addresses
Primary practice location
21760 FL-54 #102
Lutz, FL 33549
Mailing address
8435 Panahan Dr
Weeki Wachee, FL 34613-4532
Phone (727) 267-0613
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 |
|---|---|---|---|
| PTA30231 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vera Path Therapy, LLC | Physical Therapy Assistant | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754870400000",
"number": "1609751338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8435 PANAHAN DR",
"city": "WEEKI WACHEE",
"state": "FL",
"postal_code": "346134532",
"telephone_number": "727-267-0613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21760 FL-54 #102",
"city": "LUTZ",
"state": "FL",
"postal_code": "33549",
"telephone_number": "813-252-0561"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "LARA",
"middle_name": "MICHAELA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-11",
"last_updated": "2025-08-11",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA30231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lutz, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.