MEDICARE: PATRICIA J DURY M.D.

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
2	31898	OTHER	FL	BLUE CROSS

General Provider Information

NPI Number	:	1326036518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA J DURY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 150207
Second Line	:
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	:	1003 DEL PRADO BLVD S
Second Line	:	STE 303
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-3601
Country	:	US
Telephone Number	:	239-945-5015
Fax Number	:	239-945-5017

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	03/16/2017

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