Provider Demographics
NPI:1194506071
Name:MEDICAL PRESTIGE SERVICES CORP
Entity type:Organization
Organization Name:MEDICAL PRESTIGE SERVICES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:YANET
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:305-733-1450
Mailing Address - Street 1:1613 NELSON RD N
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-4053
Mailing Address - Country:US
Mailing Address - Phone:239-244-2022
Mailing Address - Fax:239-402-2844
Practice Address - Street 1:2816 DEL PRADO BLVD S STE 4
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7285
Practice Address - Country:US
Practice Address - Phone:239-244-2022
Practice Address - Fax:239-402-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty