Individual
ERICA LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11300 NE 2ND AVE, MIAMI SHORES, FL 33161-6628
(305) 899-3000
Mailing address
11855 SW 123RD AVE, MIAMI, FL 33186-5048
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/16/2023
Last updated
08/16/2023
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