Individual
DR. ALEXEI MIKHAILOVICH PRYTKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D, PHD
Contact information
Practice address
10870 US ONE N UNIT 104, PONTE VEDRA, FL 32081-7804
(904) 438-2720
(904) 212-1711
Mailing address
10870 US ONE N UNIT 104, PONTE VEDRA, FL 32081-7804
(904) 438-2720
(904) 212-1711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
ME123293
FL
207Q00000X
Family Medicine Physician
Primary
ME123293
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
017980600
—
FL
01
—
UJG97
BCBS
FL
Enumeration date
05/20/2006
Last updated
08/27/2020
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