Kidskidneydoc LLC

NPI #1790971786 in Orlando, Florida

Provider Information

NPI Number: 1790971786
Entity Type: Organization
Organization Name: Kidskidneydoc LLC
Primary Specialty: Specialist
Enumeration Date: Sep 24, 2007
Last Updated: Sep 24, 2007

Practice Location

Address: 203 ERNESTINE ST
Address 2: SUITE A
City: Orlando
State: Florida
ZIP Code: 32801-3621
Phone: (407) 843-6110

Authorized Official

Name: DR. NORMAN DALE PRYOR, MD
Title: PEDIATRIC NEPROLOGIST
Phone: (407) 876-0772

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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