PRUDENCIO E. LAROYA, M.D. PA
Ambulatory Health at 23 St, Fort Pierce, FL

License number
Florida ME0044748
Category
Ambulatory Health
Type
Medical Specialty
Owner
Name: PRUDENCIO ESTOLERO LAROYA M.D.
Title: OWNER
Phone: (772) 466-2045
Address
Address
1801 S 23Rd St SUITE 3, Fort Pierce, FL 34950
National Provider ID: 1295747806
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PRUDENCIO E. LAROYA, M.D., PA

1801 S 23 St SUITE 3, Fort Pierce, FL 34950

Registration:
Jul 31, 1985
State ID:
H69065
Business type:
Florida Profit Corporation
President:
Prudencio E. Laroya (President), 1801 S 23 St STE 3, Fort Pierce, FL 34950 (Physical)
Agent:
Prudencio Laroya,1801 S 23 St SUITE 3, Fort Pierce, FL 34950 (Physical)
EIN:
59-2556303

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