Larrea, Kelly

Larrea, Kelly is an sole proprietor health care provider with primary practice located at 160 E Lake Howard Dr , Winter Haven FL 33881-3155. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Larrea, Kelly can be contacted via phone (863) 299-1251.

Contact Information

Primary practice address
160 E Lake Howard Dr Winter Haven FL 33881-3155
Phone: (863) 299-1251
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2679 Florida

Profile Details

NPI number 1205351020
LBN Legal business name Larrea, Kelly
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 14th, 2017
Last updated Sep 12th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205351020 NPPES
Florida MEDICAID 108977700

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