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General NPI Number Information
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NPI Number | 1649246471
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Entity Type | Individual
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Provider Name | PRANAB RAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 03/19/2012
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Provider Practice Location Address
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Address Line | 11950 COUNTY ROAD 101 SUITE 105
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City | THE VILLAGES
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State | FL
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Zip | 32162-9332
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Country | US
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Telephone | 352-391-6190
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Fax | 352-391-6199
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Provider Business Mailing Address
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Address Line | 401 MANATEE AVE E
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City | BRADENTON
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State | FL
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Zip | 34208-1131
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Country | US
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Telephone | 941-807-6166
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Fax | 941-748-7878
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME31891
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License Number State | FL
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