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General NPI Number Information
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NPI Number | 1063177145
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Entity Type | Organization
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Legal Business Name | DUENAS MEDICAL CORP
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Dates
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Enumeration Date | 11/03/2021
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 3203 CONWAY RD STE 200
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City | ORLANDO
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State | FL
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Zip | 32812-7362
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Country | US
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Telephone | 407-730-3055
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Fax |
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Provider Business Mailing Address
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Address Line | 3203 CONWAY RD STE 200
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City | ORLANDO
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State | FL
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Zip | 32812-7362
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Country | US
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Telephone | 407-730-3055
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL DUENAS
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Credential |
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Telephone | 321-732-1871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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