Provider Demographics
NPI:1902832843
Name:LARACUENTE, PEDRO (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:
Last Name:LARACUENTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4363
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00681-4363
Mailing Address - Country:US
Mailing Address - Phone:787-832-9306
Mailing Address - Fax:787-265-8442
Practice Address - Street 1:114 CALLE MCKINLEY W
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-3875
Practice Address - Country:US
Practice Address - Phone:787-832-9306
Practice Address - Fax:787-265-8442
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0027341OtherTRIPLE S