Healthcare Provider Details

I. General information

NPI: 1710453022
Provider Name (Legal Business Name): DURAN MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14150 SW 119TH AVE STE 102
MIAMI FL
33186-6012
US

IV. Provider business mailing address

14150 SW 119TH AVE STE 102
MIAMI FL
33186-6012
US

V. Phone/Fax

Practice location:
  • Phone: 786-709-9362
  • Fax: 786-709-9364
Mailing address:
  • Phone: 786-709-9362
  • Fax: 786-709-9364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YOLANDA CASTILLO
Title or Position: VICE PRESIDENT
Credential: RN
Phone: 786-709-9362