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General NPI Number Information
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NPI Number | 1003875188
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Entity Type | Individual
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Provider Name | ZULMA NAHIR LARACUENTE MD
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Gender | Female
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 176 VERSAILLES BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2493
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Country | US
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Telephone | 318-445-9331
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Fax | 318-619-6899
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Provider Business Mailing Address
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Address Line | 176 VERSAILLES BLVD
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City | ALEXANDRIA
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State | LA
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Zip | 71303-2493
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Country | US
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Telephone | 318-445-9331
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Fax | 318-619-6899
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD.202029
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME84557
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License Number State | FL
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