Provider Demographics
NPI:1740611607
Name:TORRENTE, LARA MARIE FONTAN (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:LARA
Middle Name:MARIE FONTAN
Last Name:TORRENTE
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:MRS
Other - First Name:LARA
Other - Middle Name:MARIE
Other - Last Name:FONTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:4175 W 20TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-5874
Mailing Address - Country:US
Mailing Address - Phone:786-209-2140
Mailing Address - Fax:
Practice Address - Street 1:4175 W 20TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-5874
Practice Address - Country:US
Practice Address - Phone:786-209-2140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16-24332106S00000X
FL1-21-56735103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician