Basic Information
| Provider Information | |||||||||
| NPI: | 1710394606 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DURAN | ||||||||
| FirstName: | GLORIA | ||||||||
| MiddleName: | MERCEDES | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15105 NW 77TH AVE FL 4 | ||||||||
| Address2: | |||||||||
| City: | MIAMI LAKES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330147803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056498100 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11348 QUAIL ROOST DR | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331576567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052531660 | ||||||||
| FaxNumber: | 3052535775 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2014 | ||||||||
| LastUpdateDate: | 07/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1699532 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.