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NPI Code Detail

MEDICARE: DR. CHRISTINA GAYLE PROSE M.D.

MEDICARE: DR. CHRISTINA GAYLE PROSE M.D.
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
1207Q00000XFamily Medicine PhysicianBP10046757TX
2207Q00000XFamily Medicine Physician40145SC
3207Q00000XFamily Medicine PhysicianME137610FL

Other Identifiers

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

General Provider Information

NPI Number : 1871930743
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHRISTINA GAYLE PROSE M.D.
Provider Business Mailing Address
First Line : 7240 7TH PL N
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-3801
Country : US
Telephone Number : 561-969-6663
Fax Number : 561-721-3106
Provider Business Practice Location Address
First Line : 7240 7TH PL N
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33411-3801
Country : US
Telephone Number : 561-969-6663
Fax Number : 561-721-3106
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2013
Last Update Date : 02/24/2023

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