Provider Demographics
NPI:1023182839
Name:PREVEL, CHRISTOPHER DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:DEAN
Last Name:PREVEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5979 VINELAND RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7800
Mailing Address - Country:US
Mailing Address - Phone:407-352-1818
Mailing Address - Fax:407-352-1814
Practice Address - Street 1:5979 VINELAND RD
Practice Address - Street 2:SUITE 114
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7800
Practice Address - Country:US
Practice Address - Phone:407-352-1818
Practice Address - Fax:407-352-1814
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2010-07-15
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Provider Licenses
StateLicense IDTaxonomies
FLME78700208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE47346Medicare UPIN