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

Dr. Lara Diane Church, MD

Individual provider Family Medicine Physician · NPI 1043280449

Dr. Lara Diane Church, MD is a Family Practice in Ponte Vedra, Florida. Graduated from University of South Florida College of Medicine in 2002, 24 years ago. Practices with Southcentral Foundation, a 170-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
24
Trained at
University of South Florida College of Medicine
Licensed in
FL
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

141 Hilden Rd Ste 201 Credentialing Dept
Ponte Vedra, FL 32081-8400
Phone: (904) 825-1941
Fax: (904) 829-2850
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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 · Licence ME105548 (FL)

Record details

NPI number1043280449
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJanuary 26, 2006
Last updated in NPPESDecember 27, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF SOUTH FLORIDA COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Southcentral Foundation — 170 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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