Healthcare Provider Details

I. General information

NPI: 1043892425
Provider Name (Legal Business Name): DANA PRYOR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2021
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 FOREST CITY RD
ORLANDO FL
32810-3002
US

IV. Provider business mailing address

110 S WOODLAND ST
WINTER GARDEN FL
34787-3546
US

V. Phone/Fax

Practice location:
  • Phone: 407-905-8827
  • Fax: 407-660-1667
Mailing address:
  • Phone: 407-905-8827
  • Fax: 321-221-9454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR78665
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME168178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: