Healthcare Provider Details

I. General information

NPI: 1801768908
Provider Name (Legal Business Name): MADALYN L DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MADALYN L DUKE

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MAR WALT DR
FT WALTON BCH FL
32547-6708
US

IV. Provider business mailing address

8768 BROWN PELICAN CIR
NAVARRE FL
32566-3626
US

V. Phone/Fax

Practice location:
  • Phone: 850-862-1111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number33036
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: