Lara V Carballo, RPT
Physical Therapist, Pediatrics in Orlando, FL. Individual provider (NPI-1).
NPI number1124229786
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1124229786
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Lara V Carballo
- Credential
- RPT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 30, 2007
- Last updated
- Jul 8, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251P0200X | Physical Therapist, Pediatrics | PT13675 | FL | Yes |
Other names
- Lara Bouffard (Other Name)
Practice location
2739 Upper Park RdOrlando, FL 32814-6148
Phone 407-443-9696 · Fax 407-754-2624
Mailing address
2739 Upper Park RdOrlando, FL 32814-6148
Phone 407-443-9696 · Fax 407-754-2624
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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