Individual
SANDRA M PRENTISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1120 NW 14TH ST, MIAMI, FL 33136-2107
(305) 243-3564
Mailing address
1120 NW 14TH ST, MIAMI, FL 33136-2107
(305) 243-3564
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
2107
KS
231H00000X
Audiologist
Primary
AY1987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200333530A
—
KS
Enumeration date
12/19/2006
Last updated
10/13/2015
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