Provider Demographics
NPI:1093771834
Name:SZCZEPANSKI, DUANE F (MD)
Entity Type:Individual
Prefix:
First Name:DUANE
Middle Name:F
Last Name:SZCZEPANSKI
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 1:145 TURTLE BAY LN
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 TURTLE BAY LN
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-4516
Practice Address - Country:US
Practice Address - Phone:954-260-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI67404207L00000X
FLME49630207L00000X
GA028657207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL048422900Medicaid
FL148422900Medicaid
FLD42375Medicare UPIN
FL148422900Medicaid
FL048422900Medicaid
FL02791YMedicare ID - Type Unspecified