Healthcare Provider Details

I. General information

NPI: 1598381162
Provider Name (Legal Business Name): ERIC EDWARD PRADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ADVENTHEALTH WAY STE 120
PALM COAST FL
32137-4702
US

IV. Provider business mailing address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 386-586-1992
  • Fax: 386-586-1772
Mailing address:
  • Phone: 314-362-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME179461
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: