Provider Demographics
NPI:1003003302
Name:MARIA J. PRIETO, M.D. P.A.
Entity Type:Organization
Organization Name:MARIA J. PRIETO, M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRIETO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-417-2672
Mailing Address - Street 1:4327 HEDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-3307
Mailing Address - Country:US
Mailing Address - Phone:352-428-5353
Mailing Address - Fax:813-978-8577
Practice Address - Street 1:4327 HEDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3307
Practice Address - Country:US
Practice Address - Phone:352-428-5353
Practice Address - Fax:813-978-8577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK7338Medicare PIN