Provider Demographics
NPI:1467189241
Name:DUPLISSEY, JEREMY
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:DUPLISSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PARADISE PLZ # 180
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6905
Mailing Address - Country:US
Mailing Address - Phone:941-284-9008
Mailing Address - Fax:941-761-5898
Practice Address - Street 1:4590 ASHTON RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-3487
Practice Address - Country:US
Practice Address - Phone:941-284-9008
Practice Address - Fax:941-761-5898
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment