Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Las Olas Medical Management PA

Organization Counseling Psychologist · NPI 1962216457

Las Olas Medical Management PA is a Counseling Psychologist in Fort Lauderdale, Florida. Registered with an NPI since 2025.

In the registry since
2025
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

508 SW 10th St
Fort Lauderdale, FL 33315-1218
Phone: (305) 496-5998
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Counseling Psychologist Taxonomy 103TC1900X

Record details

NPI number1962216457
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Tar — Ceo · (305) 496-5998
NPI enumeratedFebruary 4, 2025
Last updated in NPPESFebruary 4, 2025
Certification dateFebruary 4, 2025
Mailing address508 Sw 10th St, Fort Lauderdale, FL 33315-1218

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