Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | ME48930 | FL |
NPI | 1487763645 |
---|---|
Provider Name | Dr. Norman Dale Pryor |
First Address | Orlando, FL 32801-3621 |
Second Address | Orlando, FL 32801-3621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |