Physician Compare National (NPI:1063498384)

HEALTHCARE PROVIDER: ENIO LUIS PRIETO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1063498384
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719037779
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090612000172
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PRIETO
	Individual professional last name
Provider First Name	ENIO
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1997
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	7935 BAY ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 3
	Group Practice or individual's line 2 address
City	SEBASTIAN
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	329583282
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100217
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	STEWARD SEBASTIAN RIVER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100316
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PALM BAY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100019
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOLMES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	100092
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WUESTHOFF MEDICAL CENTER ROCKLEDGE
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y