Prado, Martin Gino Fernandez

Prado, Martin Gino Fernandez is an individual health care provider with primary practice located at 1070 N Stone St Suite D, Deland FL 32720-0919. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Prado, Martin Gino Fernandez can be contacted via phone (386) 822-9410.

Contact Information

Primary practice address
1070 N Stone St Suite D Deland FL 32720-0919
Phone: (386) 822-9410
Fax: (386) 469-0045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X ME78262 Florida
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X ME78262 Florida

Profile Details

NPI number 1487603445
LBN Legal business name Prado, Martin Gino Fernandez
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jun 12th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487603445 NPPES
Florida MEDICAID 269724600
Florida Other 593256803

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