Healthcare Provider Details

I. General information

NPI: 1336667930
Provider Name (Legal Business Name): MRS. ZINA THERESSE DURR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3124 NW 29TH PLACE
GAINESVILLE FL
32605
US

IV. Provider business mailing address

3124 NW 29TH PLACE
GAINESVILLE FL
32605
US

V. Phone/Fax

Practice location:
  • Phone: 352-214-6667
  • Fax: 352-379-8626
Mailing address:
  • Phone: 352-214-6667
  • Fax: 352-379-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: