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NPI Code Detail

MEDICARE: PATRICE A PRADO B.A.

MEDICARE: PATRICE A PRADO B.A.
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1346379674
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICE A PRADO B.A.
Provider Business Mailing Address
First Line : 11743 TIMBERS WAY
Second Line :
City : BOCA RATON
State : FL
Zip : 33428-5568
Country : US
Telephone Number : 954-254-0331
Fax Number :
Provider Business Practice Location Address
First Line : 2900 W PROSPECT RD
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33309-2519
Country : US
Telephone Number : 954-677-3113
Fax Number : 954-497-3857
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2007
Last Update Date : 07/08/2007

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Directions to “ PATRICE A PRADO B.A.” Practice Location

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