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General NPI Number Information
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NPI Number | 1780686345
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Entity Type | Individual
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Provider Name | JULES ALVA PREUDHOMME MD
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 1228 SE 8TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33990-3210
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Country | US
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Telephone | 239-945-1105
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Fax | 239-945-4495
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Provider Business Mailing Address
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Address Line | 1228 SE 8TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33990-3210
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Country | US
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Telephone | 239-945-1105
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Fax | 239-945-4495
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME72077
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License Number State | FL
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