Healthcare Provider Details

I. General information

NPI: 1467558817
Provider Name (Legal Business Name): PRAGER SIMON & ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8950 SW 57TH AVE
PINECREST FL
33156-2133
US

IV. Provider business mailing address

8950 SW 57TH AVE
PINECREST FL
33156-2133
US

V. Phone/Fax

Practice location:
  • Phone: 305-322-4116
  • Fax: 305-666-2252
Mailing address:
  • Phone: 305-322-4116
  • Fax: 305-666-2252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME 45897
License Number StateFL

VIII. Authorized Official

Name: DR. RICHARD STEVEN PRAGER
Title or Position: MANAGING PARNTER CEO
Credential: MD FCCP
Phone: 305-322-4116