MEDICARE: DUNNETT CAPDEVILLA DURANDO D.O.

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	207N00000X	Dermatology Physician	OS12068	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HK458Z	OTHER	FL	MEDICARE ID

Other Identifiers

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

General Provider Information

NPI Number	:	1275775322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUNNETT CAPDEVILLA DURANDO D.O.

Provider Business Mailing Address
First Line	:	15051 S. TAMIAMI TRAIL
Second Line	:	SUITE 203
City	:	FORT MYERS
State	:	FL
Zip	:	33908
Country	:	US
Telephone Number	:	239-437-8810
Fax Number	:	239-313-2555

Provider Business Practice Location Address
First Line	:	413 DEL PRADO BLVD S STE 101
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5703
Country	:	US
Telephone Number	:	239-443-1500
Fax Number	:	239-443-1510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	01/15/2020

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Directions to “ DUNNETT CAPDEVILLA DURANDO D.O.” Practice Location

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