Provider Demographics
NPI:1770751539
Name:PRADO, EDUARDO I (DDS,MSD)
Entity type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:PRADO
Suffix:I
Gender:M
Credentials:DDS,MSD
Other - Prefix:DR
Other - First Name:EDUARDO
Other - Middle Name:
Other - Last Name:PRADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS,MSD
Mailing Address - Street 1:PO BOX 13089
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-7089
Mailing Address - Country:US
Mailing Address - Phone:561-630-8180
Mailing Address - Fax:
Practice Address - Street 1:784 US HIGHWAY 1
Practice Address - Street 2:SUITE 10
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4415
Practice Address - Country:US
Practice Address - Phone:561-630-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL98941223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9894OtherDENTAL LICENSE