Laroya, Prudencio Estolero

Laroya, Prudencio Estolero is an sole proprietor health care provider with primary practice located at 1801 S 23Rd St Suite 3, Fort Pierce FL 34950-4830. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Laroya, Prudencio Estolero can be contacted via phone (772) 466-2045.

Contact Information

Primary practice address
1801 S 23Rd St Suite 3 Fort Pierce FL 34950-4830
Phone: (772) 466-2045
Fax: (772) 466-8646
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X ME44748 Florida

Profile Details

NPI number 1164408142
LBN Legal business name Laroya, Prudencio Estolero
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 21st, 2005
Last updated Jan 14th, 2019 - about 5 years ago

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 1164408142 NPPES
Florida MEDICAID 003471100
Florida MEDICAID 069288300

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