Walters, Priscilla
Walters, Priscilla is an sole proprietor health care provider with primary practice located at 4901 Jefferson St , Hollywood FL 33021-7627. She recently has only one registered license in Managed Care Organizations / Preferred Provider Organization, which is considered as her primary health care specialty. Walters, Priscilla can be contacted via phone (954) 482-3360.Contact Information
Primary practice address
4901 Jefferson St
Hollywood FL 33021-7627
Phone: (954) 482-3360
Fax: (954) 894-1188
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Managed Care Organizations / Preferred Provider Organization | 305R00000X | AL12519 | Florida |
Profile Details
| NPI number | 1629515226 |
|---|---|
| LBN Legal business name | Walters, Priscilla |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 21st, 2017 |
| Last updated | Jan 21st, 2017 - about 9 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 | 1629515226 | NPPES |
| Florida | MEDICAID | W436671717290 |
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