DR. JULIO LARA (NPI# 1114454915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114454915 |
| Entity Type | Individual |
| Full Name | DR. JULIO LARA |
| Credential | D.D.S. |
| Practice Address |
302 W Fletcher Ave Tampa FL 33612-3415 |
| Mailing Address |
Po Box 82969 Tampa FL 33682-2969 |
| Practice Telephone | 8133975305 |
| Mailing Telephone | 8138660930 |
| Mailing Fax Number | 8134053722 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2019-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DS041693 | PA | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 103549337-0001 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 110 S 17th St, Harrisburg, PA 171041123 | 7172329971 | 7179203039 |
| 302 W Fletcher Ave, Tampa, FL 336123415 | 8133975305 |
| Street Address |
302 W FLETCHER AVE |
| City | TAMPA |
| State | FL |
| Zip Code | 33612-3415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942246210 | David Leopoldo Lopez | Pediatrics | 302 W Fletcher Ave, Tampa, FL 33612 | 2006-06-22 |
| 1285244541 | Ericka Danielle Gray | Dentist | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2020-08-03 |
| 1144863069 | America Delgado | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2019-10-23 |
| 1235780537 | Nicolle A Abelow | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2019-09-27 |
| 1336792464 | Diana Gonzalez | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2019-07-18 |
| 1851863872 | Tiara Ross | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2019-01-02 |
| 1861987752 | Simona Ivanov | Dentist | 302 W Fletcher Ave, Tampa, FL 33612 | 2018-06-25 |
| 1396237400 | Amanda Lape | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2018-06-04 |
| 1558866939 | Jeanie Marie Menendez | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2018-03-27 |
| 1649771239 | Lakeshia Wynn | Nurse Practitioner | 302 W Fletcher Ave, Tampa, FL 33612-3415 | 2018-02-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286767 | Daniel Jimenez | Physical Therapist | 13000 Bruce B Downs Blvd, Tampa, Fl, Tampa, FL 33612 | 2020-08-19 |
| 1700426830 | Taz Stacy | Behavior Technician | 2701 University Square Drive, Tampa, FL 33612 | 2020-01-07 |
| 1841853215 | Eric Austen Keeler | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd, Mdc5, Tampa, FL 33612 | 2019-04-20 |
| 1346700242 | Caitlyn Victoria Cartwright | Student in an Organized Health Care Education/Training Program | 12901 Bruce B. Downs Blvd., Mdc5, Tampa, FL 33612 | 2019-03-25 |
| 1720552953 | Marijo Bilitski | Student in an Organized Health Care Education/Training Program | 12901 Bruce B Downs Blvd # Blvd5, Tampa, FL 33612 | 2019-01-22 |
| 1790259190 | Belkis Aleman | Nurse Practitioner | 205 E Busch Blvd, Tampa, FL 33612 | 2019-01-18 |
| 1811469133 | Stephanie Stegner | Physician Assistant | 12901 Bruce B Downs Blvd Mdc 5, Tampa, FL 33612 | 2018-12-27 |
| 1053889857 | Alysia Heather Siegel | Psychologist | 1300 Bruce B. Downs Boulevard, 116b, Tampa, FL 33612 | 2018-11-09 |
| 1295202489 | Daisy Baby Pulinilkumkalayil | Nurse Practitioner | 1426 W. Bush Blvd. Suite #105, Suite #105, Tampa, FL 33612 | 2018-10-26 |
| 1649745258 | Rachel Rene Shelton | Specialist/Technologist | Orthopedics and Sports Medicine, 13330 Usf Laurel Drive, Tampa, FL 33612 | 2018-10-10 |
| Find all providers in zip 33612 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033742499 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 8682 Hunters Village Rd, Tampa, FL 33647-3778 | 2020-02-13 |
| 1194387118 | Matthew Sorsok | Dentist | 8406 Wilsky Blvd, Tampa, FL 33615-1515 | 2019-06-29 |
| 1922666056 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 13805 Nine Eagles Dr, Tampa, FL 33626-3002 | 2019-06-04 |
| 1346728425 | Buckenheimer & Bulnes, D.m.d.'s P.a. | Dentist | 3906 W. Neptune St., Tampa, FL 33629-5829 | 2018-08-01 |
| 1700308855 | Neil Bradley Seaver | Dentist | 16562 N Dale Mabry Hwy, Tampa, FL 33618-1325 | 2017-07-11 |
| 1801316310 | Affiliated Dental Specialist Pl | Dentist | 13129 N Dale Mabry Hwy Ste H, Tampa, FL 33618-2444 | 2017-06-26 |
| 1215457767 | Affiliated Dental Specialist Pl | Dentist | 17401 Commerce Park Blvd Ste 101, Tampa, FL 33647-3507 | 2017-06-26 |
| 1316479959 | Jennifer Lindsay Kucko | Dentist | 12113 W Linebaugh Ave, Tampa, FL 33626-1732 | 2017-04-02 |
| 1063865673 | South Tampa Dental Studio | Dentist | 4306 West Kensington Ave., Tampa, FL 33629 | 2016-07-19 |
| 1821441601 | Nicholas K. Mickelson | Dentist | 10041 W Hillsborough Ave, Tampa, FL 33615-3002 | 2016-07-18 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.