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NPI Code Detail

MEDICARE: JOSEPH DUDA APRN

MEDICARE: JOSEPH DUDA APRN
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
1363L00000XNurse PractitionerAPRN11006043FL
2163W00000XRegistered NurseRN9292509FL

Other Identifiers

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

General Provider Information

NPI Number : 1609408939
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH DUDA APRN
Provider Business Mailing Address
First Line : 508 20TH ST
Second Line :
City : NICEVILLE
State : FL
Zip : 32578-3370
Country : US
Telephone Number : 850-420-1696
Fax Number :
Provider Business Practice Location Address
First Line : 2010 LEWIS TURNER BLVD
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32547-1352
Country : US
Telephone Number : 850-530-7070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2020
Last Update Date : 02/05/2020

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