Individual
CAROL RENE PREUD'HOMME
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8333 N DAVIS HWY, PENSACOLA, FL 32514-6050
(850) 494-4885
(850) 494-4910
Mailing address
8333 N DAVIS HWY, PENSACOLA, FL 32514-6050
(850) 494-4885
(850) 494-4910
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
ME92522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01547
BSFL
—
01
—
7927061
AETNA
FL
Enumeration date
12/13/2005
Last updated
07/08/2007
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