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Individual
DR. TIRSO MARK LARA
Active
Individual
DR. TIRSO MARK LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME93684
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273396000
—
FL
01
—
28741
BLUE CROSS BLUE SHEILD
FL
01
—
301162
COMPBENEFITS CORPORATION
FL
01
—
650560968
UNITED
FL
01
—
7799557
AETNA
FL
Enumeration date
08/12/2005
Last updated
03/22/2021
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