Individual
DR. ANGEL PREVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 HICKORY ST, MELBOURNE, FL 32901
(321) 434-1771
(321) 434-1775
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME104543
FL
208M00000X
Hospitalist Physician
Primary
ME104543
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001484800
—
FL
01
—
CP332W
HFMG FL MEDICARE
FL
01
—
P01648229
RR MEDICARE
FL
Enumeration date
10/01/2008
Last updated
10/26/2023
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