Individual provider Active NPI

Jessica Angela Morlok-Prince, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Coral Gables, FL
National Provider Identifier
1124224472
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
ME99016 Issued in FL
Practice address
5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423
Phone
(305) 661-1515
NPI assigned
Jun 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ME 99016 FL
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X ME99016 FL Primary

Addresses

Primary practice location

5955 Ponce de Leon Blvd
Coral Gables, FL 33146-2423

Mailing address

307 Blossom LN
Palm Beach Shores, FL 33404-5708
Phone (561) 494-2804

Other identifiers 1

IdentifierTypeStateIssuer
99016OtherFLME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161003002451 FL Practitioner - Pediatric Medicine 4284921479 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 99016FLMDPediatrics Physician
ME99016FLMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Pediatric Services, PA CurrentSince Jul 4, 2016 Accepting new patients

Locations

2815 S Seacrest Blvd
Boynton Beach, FL 33435
Phone (561) 732-1277

5955 Ponce de Leon Blvd
Coral Gables, FL 33146
Phone (305) 662-8668

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1124224472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 BLOSSOM LN",
            "city": "PALM BEACH SHORES",
            "state": "FL",
            "postal_code": "334045708",
            "telephone_number": "561-494-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 PONCE DE LEON BLVD",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331462423",
            "telephone_number": "305-661-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORLOK-PRINCE",
        "first_name": "JESSICA",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME 99016",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "FL",
            "license": "ME99016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ME",
            "identifier": "99016",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

Verify at the official NPI Registry.