KELLY LARREA NPI 1205351020

NPI Information

  • NPI: 1205351020
  • Provider Name: KELLY LARREA
  • Classification: Physician Assistant - 363A00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 160 E LAKE HOWARD DR
    WINTER HAVEN, FL
    ZIP 33881
  • Phone: (863) 299-1251

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NPI Details

Kelly Larrea is a physician assistant in Winter Haven, FL with 37 years of experience. The provider is a physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. Kelly Larrea NPI is 1205351020. The provider is registered as an individual entity type and is a single specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

160 E LAKE HOWARD DR
WINTER HAVEN, FL
ZIP 33881-155
Phone: (863) 299-1251

The NPI 1205351020 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Removal of impacted ear wax (HCPCS:69210)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Professional service for single injection of allergen (HCPCS:95115)
  • Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing (HCPCS:G0268)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Comprehensive hearing and speech recognition test (HCPCS:92557)
  • Test to assess middle ear function (HCPCS:92567)

The enumeration date for this NPI number is 8/14/2017 and was last updated on 9/12/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363A00000XPhysician AssistantPA2679FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1108977700MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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