Provider Demographics
NPI:1588683783
Name:LAPORTE, PACO HARRY (ARDCS)
Entity type:Individual
Prefix:MR
First Name:PACO
Middle Name:HARRY
Last Name:LAPORTE
Suffix:
Gender:M
Credentials:ARDCS
Other - Prefix:MR
Other - First Name:FRANK
Other - Middle Name:HARRY
Other - Last Name:LAPORTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARDCS
Mailing Address - Street 1:3644 SW 23RD ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-4252
Mailing Address - Country:US
Mailing Address - Phone:954-295-8397
Mailing Address - Fax:
Practice Address - Street 1:3644 SW 23RD ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33312-4252
Practice Address - Country:US
Practice Address - Phone:954-295-8397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL56367246XS1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246XS1301XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist CardiovascularSonography