Provider Demographics
NPI:1538663075
Name:LARACUENTE RODRIGUEZ, ALEC M (ND)
Entity Type:Individual
Prefix:DR
First Name:ALEC
Middle Name:M
Last Name:LARACUENTE RODRIGUEZ
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N120 COND SAN FRANCISCO MARGINAL
Mailing Address - Street 2:APARTMET 159
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959
Mailing Address - Country:US
Mailing Address - Phone:787-922-0144
Mailing Address - Fax:
Practice Address - Street 1:66 SANTACRUZ HOSPITAL SAN PABLO
Practice Address - Street 2:PLAZA SAN PABLO I SUITE 101
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-922-0144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR017171100000X
PR51175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty