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General NPI Number Information
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NPI Number | 1073808200
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Entity Type | Individual
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Provider Name | DEANDREA YVONNE DUFFUS D.P.M
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Gender | Female
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 110 POND CT STE 101
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City | DEBARY
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State | FL
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Zip | 32713-2717
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Country | US
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Telephone | 386-777-3266
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Fax | 386-774-9096
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Provider Business Mailing Address
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Address Line | PO BOX 530730
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City | DEBARY
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State | FL
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Zip | 32753-0730
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Country | US
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Telephone | 904-355-1553
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3632
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License Number State | FL
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