MEDICARE: MEDICAL PRESTIGE SERVICES CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	163WP0808X	Psychiatric/Mental Health Registered Nurse
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
3	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194506071
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL PRESTIGE SERVICES CORP

Provider Business Mailing Address
First Line	:	2816 DEL PRADO BLVD S STE 4
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7285
Country	:	US
Telephone Number	:	239-244-2022
Fax Number	:	239-402-2844

Provider Business Practice Location Address
First Line	:	2816 DEL PRADO BLVD S STE 4
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-7285
Country	:	US
Telephone Number	:	239-244-2022
Fax Number	:	239-402-2844

Authorized Official
Title or Position	:	CEO
Name	:	YANET HERNANDEZ
Credential	:
Telephone Number	:	305-733-1450

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	09/17/2025

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Directions to “MEDICAL PRESTIGE SERVICES CORP ” Practice Location

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