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Contact Information

PRISCILLA WALTERS
4901 JEFFERSON ST
HOLLYWOOD, FL33021-7627
 Phone: 954-482-3360
 Fax: 954-894-1188
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for PRISCILLA WALTERS · (Female)

NPI Number 1629515226
Status Active
Credentials
Entity Individual
Enumeration date 01/21/2017
Last updated 01/21/2017 - About 9 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # AL12519
  • FL Medicaid W436671717290
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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