Prince, Andre Stephen
Prince, Andre Stephen is an individual health care provider with primary practice located at 60 Memorial Medical Pkwy , Palm Coast FL 32164-5980. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Prince, Andre Stephen can be contacted via phone (386) 586-2000.Contact Information
Primary practice address
60 Memorial Medical Pkwy
Palm Coast FL 32164-5980
Phone: (386) 586-2000
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | ME99299 | Florida |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME 99299 | Florida |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 57561 | Kentucky |
Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME99299 | Florida |
Profile Details
NPI number | 1548482151 |
---|---|
LBN Legal business name | Prince, Andre Stephen |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 3rd, 2007 |
Last updated | May 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1548482151 | NPPES |
Florida | MEDICAID | '000709500 |
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