MEDICARE: DUVAL MEDICAL, P.A.

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	208800000X	Urology Physician

General Provider Information

NPI Number	:	1780473298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUVAL MEDICAL, P.A.

Provider Business Mailing Address
First Line	:	2064 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3810
Country	:	US
Telephone Number	:	859-550-6526
Fax Number	:

Provider Business Practice Location Address
First Line	:	2064 PARK ST
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32204-3810
Country	:	US
Telephone Number	:	859-550-6526
Fax Number	:

Authorized Official
Title or Position	:	COMPLIANCE OFFICER
Name	:	JOSHUA E FAUCETT
Credential	:	DNP
Telephone Number	:	859-550-6526

Provider Enumeration Date	:	05/01/2025
Last Update Date	:	05/01/2025

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Directions to “DUVAL MEDICAL, P.A. ” Practice Location

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