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General NPI Number Information
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NPI Number | 1124219399
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Entity Type | Organization
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Legal Business Name | JUAN P DUARTE MD, PA
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 08/05/2007
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Provider Practice Location Address
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Address Line | 18926 S DIXIE HWY
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City | CUTLER BAY
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State | FL
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Zip | 33157-7711
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Country | US
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Telephone | 305-278-9677
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Fax | 305-278-7757
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Provider Business Mailing Address
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Address Line | 18926 S DIXIE HWY
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City | CUTLER BAY
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State | FL
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Zip | 33157-7711
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Country | US
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Telephone | 305-278-9677
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Fax | 305-278-7757
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JUAN P DUARTE
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Credential | M.D.
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Telephone | 305-278-9677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | ME82779
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME82779
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License Number State | FL
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