Provider Demographics
NPI:1346550589
Name:DURAN, MECHELL ANGELLA (NP)
Entity Type:Individual
Prefix:MRS
First Name:MECHELL
Middle Name:ANGELLA
Last Name:DURAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 N FEDERAL HWY
Mailing Address - Street 2:STE-A27
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4608
Mailing Address - Country:US
Mailing Address - Phone:954-938-9966
Mailing Address - Fax:
Practice Address - Street 1:4701 N FEDERAL HWY
Practice Address - Street 2:STE-A27
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4608
Practice Address - Country:US
Practice Address - Phone:954-938-9966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9259129363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily