=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023578895
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAMES M DUROSS IV APRN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2019
-----------------------------------------------------
Last Update Date | 04/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1507 S TUTTLE AVE
-----------------------------------------------------
City | SARASOTA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34239-2608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-722-0484
-----------------------------------------------------
Fax | 833-903-0130
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 157 BALTIMORE ST STE 100
-----------------------------------------------------
City | CUMBERLAND
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21502-2472
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-722-0484
-----------------------------------------------------
Fax | 833-903-0130
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | APRN11002128
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208VP0014X
-----------------------------------------------------
Taxonomy Name | Interventional Pain Medicine Physician
-----------------------------------------------------
License Number | APRN11002128
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | SP020029
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | APRN11002128
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------