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General NPI Number Information
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NPI Number | 1750572103
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Entity Type | Individual
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Provider Name | JEAN MAURICE DURE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2007
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1200 NE 55TH BLVD
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City | GAINESVILLE
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State | FL
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Zip | 32641-2783
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Country | US
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Telephone | 904-964-7732
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Fax | 904-964-3829
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Provider Business Mailing Address
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Address Line | 9816 SW 150TH RUN
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City | LAKE BUTLER
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State | FL
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Zip | 32054-7120
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Country | US
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Telephone |
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Fax | 904-964-3829
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16163
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License Number State | PR
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