Provider Demographics
NPI:1164638078
Name:DANIEL M. DURANTE O.D.P.A.
Entity type:Organization
Organization Name:DANIEL M. DURANTE O.D.P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:DURANTE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:772-692-3232
Mailing Address - Street 1:3468 NW FEDERAL HWY
Mailing Address - Street 2:
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-4440
Mailing Address - Country:US
Mailing Address - Phone:772-692-3233
Mailing Address - Fax:772-692-2844
Practice Address - Street 1:3468 NW FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-4440
Practice Address - Country:US
Practice Address - Phone:772-692-3233
Practice Address - Fax:772-692-2844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0863620001Medicare NSC