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:
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Health care specialties

SpecialtyCodeLicense #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 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548482151 NPPES
Florida MEDICAID '000709500

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