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Individual

DR. MANOJ PRAKASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2758 US 1 SOUTH, ST AUGUSTINE, FL 32086
(904) 797-2338
Mailing address
PO BOX 860120, ST AUGUSTINE, FL 32086-0120
(904) 797-2338

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME41060
FL
207RP1001X
Pulmonary Disease Physician
Primary
ME41060
FL
207RS0012X
Sleep Medicine (Internal Medicine) Physician
ME41060
FL

Other

Enumeration date
08/09/2006
Last updated
06/21/2010
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