Provider Demographics
NPI:1427463769
Name:SANTORO, LARA MICHELLE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:LARA
Middle Name:MICHELLE
Last Name:SANTORO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:MICHELLE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1285 CLASSIC CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-1241
Mailing Address - Country:US
Mailing Address - Phone:772-633-6898
Mailing Address - Fax:
Practice Address - Street 1:1000 36TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4862
Practice Address - Country:US
Practice Address - Phone:772-567-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3290802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily