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Organization
PRIMARY CARE MEDICAL SERVICES
Active
Organization
PRIMARY CARE MEDICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE-ALICE LARA MD (VICE PRESIDENTD)
(954) 517-9166
Entity
Organization
Contact information
Practice address
10000 STIRLING RD, SUITE 3, HOLLYWOOD, FL 33024-8067
(954) 517-9166
(954) 517-9167
Mailing address
PO BOX 848127, PEMBROKE PINES, FL 33084-0127
(954) 517-9166
(954) 517-9167
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME69293
FL
208000000X
Pediatrics Physician
ME79139
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
74888
BCBS
FL
Enumeration date
02/28/2007
Last updated
09/11/2025
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