Healthcare Provider Details

I. General information

NPI: 1093397986
Provider Name (Legal Business Name): JOSHUA MARSHALL PRYOR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3090 CARUSO CT STE 20
ORLANDO FL
32806-8565
US

IV. Provider business mailing address

3090 CARUSO CT STE 20
ORLANDO FL
32806-8565
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-5236
  • Fax:
Mailing address:
  • Phone: 321-841-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License NumberME168317
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: