Provider Demographics
NPI:1417188145
Name:RICARDO L. DURAN D.D.S., M.S.,P.A.
Entity Type:Organization
Organization Name:RICARDO L. DURAN D.D.S., M.S.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:L
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-735-5000
Mailing Address - Street 1:18766 US HIGHWAY 441
Mailing Address - Street 2:
Mailing Address - City:MOUNT DORA
Mailing Address - State:FL
Mailing Address - Zip Code:32757-6723
Mailing Address - Country:US
Mailing Address - Phone:352-735-5000
Mailing Address - Fax:352-735-5600
Practice Address - Street 1:18766 US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:MOUNT DORA
Practice Address - State:FL
Practice Address - Zip Code:32757-6723
Practice Address - Country:US
Practice Address - Phone:352-735-5000
Practice Address - Fax:352-735-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10275261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental