MEDICARE: PATRICIA J. DURY MD, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	ME 70701	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134524366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA J. DURY MD, PA

Provider Business Mailing Address
First Line	:	PO BOX 150207
Second Line	:	SUITE # 202
City	:	CAPE CORAL
State	:	FL
Zip	:	33915-0207
Country	:	US
Telephone Number	:	239-945-5015
Fax Number	:	239-945-5017

Provider Business Practice Location Address
First Line	:	1425 VISCAYA PKWY
Second Line	:	SUITE # 202
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3294
Country	:	US
Telephone Number	:	239-945-5015
Fax Number	:	239-945-5017

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	PATRICIA JEAN DURY
Credential	:	M.D.
Telephone Number	:	239-826-8771

Provider Enumeration Date	:	10/30/2014
Last Update Date	:	10/30/2014

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