Provider Demographics
NPI:1275775322
Name:DURANDO, DUNNETT CAPDEVILLA (DO)
Entity Type:Individual
Prefix:
First Name:DUNNETT
Middle Name:CAPDEVILLA
Last Name:DURANDO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15051 S. TAMIAMI TRAIL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908
Mailing Address - Country:US
Mailing Address - Phone:239-437-8810
Mailing Address - Fax:239-313-2555
Practice Address - Street 1:413 DEL PRADO BLVD S STE 101
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-5703
Practice Address - Country:US
Practice Address - Phone:239-443-1500
Practice Address - Fax:239-443-1510
Is Sole Proprietor?:No
Enumeration Date:2009-04-02
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS12068207N00000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHK458ZOtherMEDICARE ID