Provider Demographics
NPI:1427031855
Name:DALOS, NANCY PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:PATRICIA
Last Name:DALOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1829
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33757-1829
Mailing Address - Country:US
Mailing Address - Phone:727-532-0002
Mailing Address - Fax:727-532-1318
Practice Address - Street 1:1201 5TH AVENUE NORTH
Practice Address - Street 2:SUITE 202
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1410
Practice Address - Country:US
Practice Address - Phone:727-820-7701
Practice Address - Fax:727-820-7700
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME511752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046774000Medicaid
FLP00699967OtherRAILROAD MEDICARE PROVIDER NUMBER
FL04669ZMedicare PIN
FLP00699967OtherRAILROAD MEDICARE PROVIDER NUMBER