Organization
KIDSKIDNEYDOC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NORMAN DALE PRYOR MD (PEDIATRIC NEPROLOGIST)
(407) 876-0772
Entity
Organization
Contact information
Practice address
203 ERNESTINE ST, SUITE A, ORLANDO, FL 32801-3621
(407) 843-6110
Mailing address
203 ERNESTINE ST, SUITE A, ORLANDO, FL 32801-3621
(407) 843-6110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME 48930
FL
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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