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General NPI Number Information
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NPI Number | 1992819957
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Entity Type | Individual
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Provider Name | PRAYUK A. WARAN MD
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Gender | Male
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 999 N STONE ST STE B
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City | DELAND
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State | FL
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Zip | 32720-0800
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Country | US
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Telephone | 386-740-4017
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Fax | 386-740-4017
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Provider Business Mailing Address
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Address Line | 999 N STONE ST STE B
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City | DELAND
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State | FL
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Zip | 32720-0800
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Country | US
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Telephone | 386-740-4017
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Fax | 386-740-4017
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 01041051A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | G130667
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME155251
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License Number State | FL
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