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General NPI Number Information
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NPI Number | 1396136842
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Entity Type | Individual
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Provider Name | ANALISA DUNCAN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 490 BRIGHTON AVE NE PALM BAY
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City | PALM BAY
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State | FL
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Zip | 32907-2023
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Country | US
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Telephone | 321-951-4070
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Fax |
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Provider Business Mailing Address
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Address Line | 410 MERCER ST NW PALM BAY
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City | PALM BAY
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State | FL
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Zip | 32907-2933
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Country | US
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Telephone | 617-438-2866
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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 | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | AL10937
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License Number State | FL
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