Individual
LARA ENID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
109 STATE ST, 5TH FL, BOSTON, MA 02109-2906
(617) 505-1520
(617) 928-8401
Mailing address
109 STATE ST, 5TH FL, BOSTON, MA 02109-2906
(617) 505-1520
(617) 928-8401
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036167275
IL
207Q00000X
Family Medicine Physician
78755
GA
207Q00000X
Family Medicine Physician
TPME4914
FL
Other
Enumeration date
06/06/2016
Last updated
03/20/2026
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