Healthcare Provider Details

I. General information

NPI: 1871805176
Provider Name (Legal Business Name): KASEY PRYCE D.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2010
Last Update Date: 07/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 41ST ST SUITE 201
MIAMI BEACH FL
33140-3637
US

IV. Provider business mailing address

2383 FLAMINGO DR APT. 5
MIAMI BEACH FL
33140-4802
US

V. Phone/Fax

Practice location:
  • Phone: 305-764-4722
  • Fax:
Mailing address:
  • Phone: 305-764-4722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2510
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: