Individual
MARIELA BACERIO LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
2778 US HIGHWAY 27 S, AVON PARK, FL 33825-9755
(863) 358-0500
Mailing address
2778 US HIGHWAY 27 S, AVON PARK, FL 33825-9755
(863) 358-0500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
217589
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11038482
FL
Other
Enumeration date
03/11/2019
Last updated
08/17/2025
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