Healthcare Provider Details

I. General information

NPI: 1477269314
Provider Name (Legal Business Name): KAYA CATERINA DUKES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2023
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 STILL RD
PIERSON FL
32180-2676
US

IV. Provider business mailing address

680 STILL RD
PIERSON FL
32180-2676
US

V. Phone/Fax

Practice location:
  • Phone: 386-405-7784
  • Fax:
Mailing address:
  • Phone: 386-405-7784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9120320
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: