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NPI Code Detail

MEDICARE: MICHAEL EDWARD DUTTON

MEDICARE: MICHAEL EDWARD DUTTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1851257737
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL EDWARD DUTTON
Provider Business Mailing Address
First Line : 1526 RIVERTRACE DR
Second Line :
City : FLEMING ISLAND
State : FL
Zip : 32003-7777
Country : US
Telephone Number : 904-579-4779
Fax Number :
Provider Business Practice Location Address
First Line : 2377 MARKET DR
Second Line :
City : FLEMING ISLAND
State : FL
Zip : 32003-4326
Country : US
Telephone Number : 904-579-4779
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ MICHAEL EDWARD DUTTON ” Practice Location

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