Individual
DR. ANDRE STEPHEN PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
60 MEMORIAL MEDICAL PKWY, PALM COAST, FL 32164-5980
(386) 586-2000
Mailing address
60 MEMORIAL MEDICAL PKWY, PALM COAST, FL 32164-5980
(386) 586-2000
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
ME99299
FL
2085R0202X
Diagnostic Radiology Physician
57561
KY
2085R0202X
Diagnostic Radiology Physician
ME 99299
FL
2085R0202X
Diagnostic Radiology Physician
Primary
ME99299
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
'000709500
—
FL
Enumeration date
05/03/2007
Last updated
05/12/2023
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