Individual
LARA COSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1700 S TAMIAMI TRL, SARASOTA, FL 34239-3509
(941) 917-8720
(941) 917-1875
Mailing address
PO BOX 947407, ATLANTA, GA 30394-7407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9226458
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G3741
BLUE SHIELD OF FL
FL
01
—
P00262909
RAILROAD MEDICARE
FL
Enumeration date
09/06/2006
Last updated
04/21/2023
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