Provider Demographics
NPI:1477511350
Name:CUMBERBATCH, DUANE F (DPM)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:F
Last Name:CUMBERBATCH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 BOARDROOM CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33919-4888
Mailing Address - Country:US
Mailing Address - Phone:239-481-7000
Mailing Address - Fax:239-481-8150
Practice Address - Street 1:8851 BOARDROOM CIR
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33919-4888
Practice Address - Country:US
Practice Address - Phone:239-481-7000
Practice Address - Fax:239-481-8150
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004021616213E00000X
IN07001025A213E00000X
FLPO3354213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00642732OtherRAILROAD MEDICARE
FLP00642732OtherRAILROAD MEDICARE
FLAP186UMedicare PIN
FL6131490001Medicare NSC