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JOHN EDWARD PRIOLEAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
400 HEALTH PARK BLVD STE 300, ST AUGUSTINE, FL 32086-5784
(904) 819-4082
(904) 819-5056
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
(904) 819-4082
(904) 819-5056

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
ME94505
FL
207R00000X
Internal Medicine Physician
ME94505
FL
208M00000X
Hospitalist Physician
Primary
ME94505
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1776587
CIGNA
FL
01
30942
FL BLUE
FL
01
P00715723
RAILROAD MEDICARE
FL
Enumeration date
01/17/2006
Last updated
09/29/2017
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