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Individual

DR. DAN T. TUDOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
419 E 1ST ST, SANFORD, FL 32771-1407
(407) 323-5047
(407) 323-5048
Mailing address
PO BOX 1881, SANFORD, FL 32772-1881
(407) 323-5047
(407) 323-5048

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
ME 94020
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
275514900
FL
01
DF4787
MEDICARE RAILROAD
FL
01
P00369212
MEDICARE RAILROAD
FL
Enumeration date
02/23/2006
Last updated
06/04/2012
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