Individual
AMANDA MICHELLE LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
11100 NW 27TH ST, DORAL, FL 33172-5001
(305) 591-0020
(305) 591-9251
Mailing address
2401 OVERBROOK ST APT 206, MIAMI, FL 33133-3197
(786) 255-0002
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL4328
FL
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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