Bernard A. Prudencio M.d.pa

NPI #1942510672 in Welaka, Florida

Provider Information

NPI Number: 1942510672
Entity Type: Organization
Organization Name: Bernard A. Prudencio M.d.pa
Primary Specialty: General Practice
Enumeration Date: Oct 15, 2010
Last Updated: Oct 15, 2010

Practice Location

Address: 673 THIRD AVE
City: Welaka
State: Florida
ZIP Code: 32193-0619
Phone: (386) 467-9047

Authorized Official

Name: REBECCA PRUDENCIO
Title: OFFICE MANAGER
Phone: (386) 467-9047

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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