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:
Health care specialties
| Specialty | Code | License # | 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 3 years ago |
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 | 1487603445 | NPPES |
| Florida | MEDICAID | 269724600 | |
| Florida | Other | 593256803 |
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