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NPI Code Detail

MEDICARE: KEVIN ARIEL LARA ARNP

MEDICARE: KEVIN ARIEL LARA ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner9328395FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396266896
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN ARIEL LARA ARNP
Provider Business Mailing Address
First Line : 4765 W ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3838
Country : US
Telephone Number : 561-453-2273
Fax Number : 561-536-5620
Provider Business Practice Location Address
First Line : 4765 W ATLANTIC AVE
Second Line :
City : DELRAY BEACH
State : FL
Zip : 33445-3838
Country : US
Telephone Number : 561-453-2273
Fax Number : 561-536-5620
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2017
Last Update Date : 02/03/2026

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