Individual
MRS. CORALIE PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2440 EMERSON DR SE, PALM BAY, FL 32909-4972
(321) 299-7687
Mailing address
2440 EMERSON DR SE, PALM BAY, FL 32909-4972
(321) 299-7687
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
AL11411
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142640100
—
FL
Enumeration date
04/08/2009
Last updated
04/08/2009
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