# LARA HEALTH AND WELLNESS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lara Health and Wellness Center, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104457977
- **Authorized official:** YONAIKA LARA (OWNER)
- **Authorized official phone:** (813) 415-2982

## Contact information

- **Practice address:** 3105 W WATERS AVE STE 105, TAMPA, FL 33614-2846
- **Practice address phone:** (813) 443-0705
- **Practice address fax:** (813) 415-2982
- **Mailing address:** 3105 W WATERS AVE STE 105, TAMPA, FL 33614-2846

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 02/07/2020