Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | DN0006100 | FL |
NPI | 1508895038 |
---|---|
Provider Name | Dr. Louis G Payor |
First Address | Winter Park, FL 32789-4679 |
Second Address | Orlando, FL 32806-1050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 12/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T94767 | (02) | FL |