CAITLYN G PRUCINSKY

STUART, FL
NPI1194720797
Former NameCAITLYN GRAHAM BATES
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: FL  PA9111020)
Additional Taxonomies363A00000X Physician Assistant
(Licence: FL  PA111020)
363A00000X Physician Assistant
(Licence: FL  PA91111020)
363AM0700X Physician Assistant, Medical
(Licence: IN  10000698A)
363AS0400X Physician Assistant, Surgical
(Licence: IN  10000698A)
363AS0400X Physician Assistant, Surgical
(Licence: IN  10000698)
Enumeration Date2005-06-20
Last Update Date2020-10-26
Business Address
CAITLYN G PRUCINSKY PA
1050 SE MONTEREY RD STE 400
STUART, FL 34994-4512
Phone number: 772-288-2400
Mailing Address
CAITLYN G PRUCINSKY PA
250 N SHADELAND AVE STE 130 PROVIDER ENROLLMENT
INDIANAPOLIS, IN 46219-4959
Phone number: