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General NPI Number Information
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NPI Number | 1497924179
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Entity Type | Organization
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Legal Business Name | DAVID B RAYNOR DPM PA
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 03/04/2009
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Provider Practice Location Address
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Address Line | 490 PLEASANT GROVE RD
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City | INVERNESS
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State | FL
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Zip | 34452-5746
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Country | US
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Telephone | 352-726-3668
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Fax | 352-726-1003
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Provider Business Mailing Address
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Address Line | 490 PLEASANT GROVE RD
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City | INVERNESS
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State | FL
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Zip | 34452-5746
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Country | US
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Telephone | 352-726-3668
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Fax | 352-726-1003
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DAVID B RAYNOR
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Credential | DPM
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Telephone | 352-726-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO2467
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License Number State | FL
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