Provider Demographics
NPI:1043097769
Name:DUO MEDICAL GROUP OF FLORIDA LLC
Entity type:Organization
Organization Name:DUO MEDICAL GROUP OF FLORIDA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, CORPORATE INITIATIVES
Authorized Official - Prefix:
Authorized Official - First Name:MEAGHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-791-0542
Mailing Address - Street 1:PO BOX 530322
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0322
Mailing Address - Country:US
Mailing Address - Phone:855-386-2799
Mailing Address - Fax:
Practice Address - Street 1:7421 RIDGE RD STE 105
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6935
Practice Address - Country:US
Practice Address - Phone:855-386-2799
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-14
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty