Provider Demographics
NPI:1457305112
Name:PRADOS, CAROLINA (DC)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:PRADOS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7881
Mailing Address - Country:US
Mailing Address - Phone:732-831-1003
Mailing Address - Fax:732-831-1007
Practice Address - Street 1:1193 BAY AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7881
Practice Address - Country:US
Practice Address - Phone:732-831-1003
Practice Address - Fax:732-831-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00524200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor