Bernard a. Prudencio M.D.PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

BERNARD A. PRUDENCIO M.D.PA

Practice address

673 Third Ave
Welaka, FL 32193-0619

Phone

(386) 467-9047

Fax

(386) 467-8512

NPI assigned

Oct 15, 2010

Last updated

Oct 15, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebecca Prudencio

Title

Office Manager

Phone

(386) 467-9047

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1942510672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "673 THIRD AVE",
            "address_2": "PO BOX 619",
            "city": "WELAKA",
            "state": "FL",
            "postal_code": "321930619",
            "telephone_number": "386-467-9047",
            "fax_number": "386-467-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "673 THIRD AVE",
            "city": "WELAKA",
            "state": "FL",
            "postal_code": "321930619",
            "telephone_number": "386-467-9047",
            "fax_number": "386-467-8512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERNARD A. PRUDENCIO M.D.PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "PRUDENCIO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "386-467-9047"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shirley Adams
• Amy Castrillo
• Katherine Mauldin, LMT
• Paula Janel Nemeth, LMT
• David L Roe, PHARMACIST
• Rural Health Care Incorporated (Aza Health)

• General Practice Physician in Welaka, FL
• Providers in Welaka, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.