Healthcare Provider Details
I. General information
NPI: 1245611128
Provider Name (Legal Business Name): AMBER DUREN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2015
Last Update Date: 07/25/2023
Certification Date: 07/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17511 N DALE MABRY HWY
LUTZ FL
33548-4521
US
IV. Provider business mailing address
5400 PINEHURST DR
SPRING HILL FL
34606-3833
US
V. Phone/Fax
- Phone: 813-962-6700
- Fax: 813-962-7799
- Phone: 352-277-5305
- Fax: 352-616-0926
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | ARNP9363085 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: