Organization
MANOJ PRAKASH MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANOJ PRAKASH MD (OWNER)
(904) 797-2338
Entity
Organization
Contact information
Practice address
2758 US 1 S, ST AUGUSTINE, FL 32086-6343
(904) 797-2338
Mailing address
PO BOX 860120, ST AUGUSTINE, FL 32086-0120
(904) 797-2338
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
06/21/2010
Last updated
09/01/2010
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