MEDICARE: DAVID PRADO

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
1	363LF0000X	Family Nurse Practitioner	95037035	CA
2	363LF0000X	Family Nurse Practitioner	358469	NY
3	363LF0000X	Family Nurse Practitioner	F06230584	FL

General Provider Information

NPI Number	:	1659054468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID PRADO

Provider Business Mailing Address
First Line	:	1680 SAINT CLAIR AVE E
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4649
Country	:	US
Telephone Number	:	786-269-3358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1680 SAINT CLAIR AVE E
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4649
Country	:	US
Telephone Number	:	786-269-3358
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2023
Last Update Date	:	01/20/2026

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Directions to “ DAVID PRADO ” Practice Location

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