Active NPI
Marie-Alice Lara, M.D.
- Pediatrics Physician
- Cooper City, FL
National Provider Identifier
1851386684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME79139
- Practice address
- 10000 Stirling Rd
Suite 3
Cooper City, FL 33024-8067 - Phone
- (954) 517-9166
- Fax
- (954) 517-9167
- NPI assigned
- Sep 19, 2005
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | ME79139 | FL | Primary |
Addresses
Primary practice location
10000 Stirling Rd
Suite 3
Cooper City, FL 33024-8067
Mailing address
PO Box 848127
Pembroke Pines, FL 33084-0127
Phone (954) 517-9166
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35540 | Other | FL | BLUE CROSS BLUE SHIELD |
| 1722315001 | Other | FL | CIGNA |
| 274662 | Other | FL | WELLCARE |
| 7477630 | Other | FL | AETNA |
| 2039274 | Other | FL | UNITED HEALTH CARE |
| 295786 | Other | FL | AV-MED |
| 170211 | Other | FL | HUMANA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207094400000",
"number": "1851386684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 848127",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330840127",
"telephone_number": "954-517-9166",
"fax_number": "954-517-9167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10000 STIRLING RD",
"address_2": "SUITE 3",
"city": "COOPER CITY",
"state": "FL",
"postal_code": "330248067",
"telephone_number": "954-517-9166",
"fax_number": "954-517-9167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARA",
"first_name": "MARIE-ALICE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-19",
"last_updated": "2008-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME79139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "35540",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1722315001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLCARE",
"identifier": "274662",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7477630",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2039274",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AV-MED",
"identifier": "295786",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "170211",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cooper City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.