Individual
DR. LARA WOLFENDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 841-5111
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 843-5270
(321) 843-5177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9346998
FL
363LA2100X
Acute Care Nurse Practitioner
APRN11017875
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
APRN11017875
FL
Other
Enumeration date
05/19/2022
Last updated
01/19/2023
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