Provider Demographics
NPI:1043043185
Name:LARACUENTE SANCHEZ, RICHARD C (DTP)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:LARACUENTE SANCHEZ
Suffix:
Gender:M
Credentials:DTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CONDOMINIO SENIDE CALLE FRANCISCO SEIN 12
Mailing Address - Street 2:APTO 7
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00917
Mailing Address - Country:US
Mailing Address - Phone:787-330-2100
Mailing Address - Fax:
Practice Address - Street 1:E6 CALLE SANTA CRUZ
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-6905
Practice Address - Country:US
Practice Address - Phone:787-330-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4657225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist