DR. PRUDENCIO ESTOLERO LAROYA M.D. NPI 1164408142

NPI Information

NPI: 1164408142
Provider Name: DR. PRUDENCIO ESTOLERO LAROYA, M.D.
Classification: Pediatrics - 208000000X
Entity Type: Individual

CLIA Number: 10D2096634

Address:
1801 S 23RD ST
SUITE 3
FORT PIERCE, FL
ZIP 34950
Phone: (772) 466-2045
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DR. Prudencio Estolero Laroya, M.D. is a pediatrics in Fort Pierce, FL. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. DR. Prudencio Estolero Laroya, M.D. NPI is 1164408142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1801 S 23RD ST
SUITE 3
FORT PIERCE, FL
ZIP 34950-830
Phone: (772) 466-2045
Fax: (772) 466-8646

The CLIA number assigned to this NPI record is 10D2096634 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/21/2005 and was last updated on 1/14/2019.

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
1	208000000X	Pediatrics		ME44748	FLORIDA	Yes

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
1	003471100	MEDICAID	FLORIDA
2	069288300	MEDICAID	FLORIDA

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: 11/14/2023

NPI Synchronization or Removal

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