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General NPI Number Information
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NPI Number | 1750420667
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Entity Type | Organization
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Legal Business Name | RONALD LARACUENTE MD PA
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 9325 GLADES RD SUITE 204
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City | BOCA RATON
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State | FL
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Zip | 33434-3988
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Country | US
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Telephone | 561-483-6772
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Fax |
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Provider Business Mailing Address
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Address Line | 9325 GLADES RD SUITE 204
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City | BOCA RATON
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State | FL
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Zip | 33434-3988
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Country | US
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Telephone | 561-483-6772
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD LARACUENTE
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Credential | MD
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Telephone | 561-483-6772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME80924
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License Number State | FL
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