Provider Demographics
NPI:1033110713
Name:DULAY, ADOLFO CARDENAS (MD)
Entity Type:Individual
Prefix:
First Name:ADOLFO
Middle Name:CARDENAS
Last Name:DULAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32341-0934
Mailing Address - Country:US
Mailing Address - Phone:850-973-2767
Mailing Address - Fax:850-973-8860
Practice Address - Street 1:228 NE HANCOCK AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2560
Practice Address - Country:US
Practice Address - Phone:850-973-2767
Practice Address - Fax:850-973-8860
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0027368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18559OtherBLUE CROSS AND BLUE SHIEL
203860OtherHEALTH EASE
050040OtherVISTA
FLCG0345OtherRAILROAD MEDICARE
D54649Medicare UPIN
203860OtherHEALTH EASE