Prudencio E. Laroya, M.D. PA

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PRUDENCIO E. LAROYA, M.D. PA

Practice address

1801 S 23Rd St
Suite 3
Fort Pierce, FL 34950-4830

Phone

(772) 466-2045

Fax

(772) 466-8646

NPI assigned

Aug 12, 2006

Last updated

Jan 14, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prudencio Estolero Laroya, M.D.NPI 1164408142

Title

Owner

Phone

(772) 466-2045

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prudencio Estolero Laroya, M.D.

  • Pediatrics Physician
  • Fort Pierce, FL
  • NPI 1164408142
  NPD Authorized official
• Emerlita Quijano Manguiat, M.D.

  • Pediatrics Physician
  • Fort Pierce, FL
  • NPI 1881788651
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547424000000",
    "number": "1295747806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 S 23RD ST",
            "address_2": "SUITE 3",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504830",
            "telephone_number": "772-466-2045",
            "fax_number": "772-466-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 S 23RD ST",
            "address_2": "SUITE 3",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504830",
            "telephone_number": "772-466-2045",
            "fax_number": "772-466-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENCIO E. LAROYA, M.D. PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-01-14",
        "status": "A",
        "authorized_official_last_name": "LAROYA",
        "authorized_official_first_name": "PRUDENCIO",
        "authorized_official_middle_name": "ESTOLERO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-466-2045",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "069288300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000366600",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003471100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon S Prince, MA, BCBA, LBA, ITDS
• Tammy Pritchard, DNP, NP-C, PMHNP-BC
• Professional Dental Alliance of Ft. Pierce, PLLC
• Professional Medical Supply, Inc.
• Progressive Orthopaedic
• Psychotherapeutic Services of Florida, in
• Publix Super Markets Inc (Publix Pharmacy #0567)
• Publix Super Markets, Inc. (Publix Pharmacy #1682)
• Diane L Pugh, DO
• Valerie O Pullen, LCSW

• Pediatrics Physician in Fort Pierce, FL
• Providers in Fort Pierce, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.