Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | ME 99016 | FL |
Y | 2080P0204X | Pediatric Emergency Doctor | ME99016 | FL |
NPI | 1124224472 |
---|---|
Provider Name | Dr. Jessica Angela Morlok-Prince |
First Address | Palm Beach Shores, FL 33404-5708 |
Second Address | Coral Gables, FL 33146-2423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2007 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
99016 | ME (01) | FL |