Organization
PRUDENCIO E. LAROYA, M.D. PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRUDENCIO ESTOLERO LAROYA M.D. (OWNER)
(772) 466-2045
Entity
Organization
Contact information
Practice address
1801 S 23RD ST, SUITE 3, FORT PIERCE, FL 34950-4830
(772) 466-2045
(772) 466-8646
Mailing address
1801 S 23RD ST, SUITE 3, FORT PIERCE, FL 34950-4830
(772) 466-2045
(772) 466-8646
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000366600
—
FL
05
—
003471100
—
FL
05
—
069288300
—
FL
Enumeration date
08/12/2006
Last updated
01/14/2019
Update your record
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