Provider Demographics
NPI:1114015823
Name:DURSO, ANTHONY MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:DURSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1150 NW 14TH ST
Mailing Address - Street 2:PAC 511
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2137
Mailing Address - Country:US
Mailing Address - Phone:305-243-1579
Mailing Address - Fax:305-243-7635
Practice Address - Street 1:1611 NW 12TH AVE
Practice Address - Street 2:JMH WW 279
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1005
Practice Address - Country:US
Practice Address - Phone:305-585-7500
Practice Address - Fax:305-243-7635
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2013-04-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME 861902085R0202X
WAMD600766062085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology