Provider Demographics
NPI:1275598708
Name:DURRANCE, DONALD WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:WILLIAM
Last Name:DURRANCE
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 1:100 SOUTH ASHLEY DRIVE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-5318
Mailing Address - Country:US
Mailing Address - Phone:813-899-6220
Mailing Address - Fax:813-985-8006
Practice Address - Street 1:100 SOUTH ASHLEY DRIVE
Practice Address - Street 2:SUITE 1500
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33602-5318
Practice Address - Country:US
Practice Address - Phone:813-899-6220
Practice Address - Fax:813-985-8006
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 497862085R0202X
FLME497862085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0464929-00Medicaid
FL275206900Medicaid
FLC76094Medicare UPIN
FL03861Medicare PIN