Provider Demographics
NPI:1679776025
Name:SALCEDO-LAUREANO, MANUEL (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:
Last Name:SALCEDO-LAUREANO
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 1:50 AVE A APT 1207
Mailing Address - Street 2:QUINTA BALDWIN
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-8792
Mailing Address - Country:US
Mailing Address - Phone:787-378-7897
Mailing Address - Fax:
Practice Address - Street 1:50 AVE A APT 1207
Practice Address - Street 2:QUINTA BALDWIN
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959-8792
Practice Address - Country:US
Practice Address - Phone:787-378-7897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16006207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine