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General NPI Number Information
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NPI Number | 1396266896
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Entity Type | Individual
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Provider Name | KEVIN ARIEL LARA ARNP
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Gender | Male
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Dates
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Enumeration Date | 07/05/2017
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 4765 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3838
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Country | US
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Telephone | 561-453-2273
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Fax | 561-536-5620
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Provider Business Mailing Address
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Address Line | 4765 W ATLANTIC AVE
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City | DELRAY BEACH
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State | FL
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Zip | 33445-3838
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Country | US
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Telephone | 561-453-2273
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Fax | 561-536-5620
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9328395
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License Number State | FL
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