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General NPI Number Information
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NPI Number | 1407881337
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Entity Type | Individual
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Provider Name | DANIEL MICHAEL DURANTE OD,PA
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 3468NWFEDERAL HWY
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City | JENSEN BEACH
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State | FL
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Zip | 34957-4440
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Country | US
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Telephone | 772-692-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 3468 NW FEDERAL HWY
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City | JENSEN BEACH
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State | FL
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Zip | 34957-4440
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Country | US
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Telephone | 772-692-2020
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC001529
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License Number State | FL
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