Organization
WILFREDO CONSTANTINO LARA MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILFREDO CONSTANTINO LARA MD (OWNER)
(305) 643-8871
Entity
Organization
Contact information
Practice address
351 NW 42ND AVE, SUITE 302, MIAMI, FL 33126-5683
(305) 643-8871
(305) 643-8872
Mailing address
PO BOX 144336, CORAL GABLES, FL 33114-4336
(305) 643-8871
(305) 643-8872
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
446289
MEDICA HEALTHCARE
FL
01
—
8796542
CIGNA
FL
Enumeration date
08/23/2007
Last updated
05/08/2008
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