Provider Demographics
NPI:1487842795
Name:ADOLFO C DULAY MD PA
Entity Type:Organization
Organization Name:ADOLFO C DULAY MD PA
Other - Org Name:MADISON FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADOLFO
Authorized Official - Middle Name:C
Authorized Official - Last Name:DULAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:850-973-4853
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:FL
Mailing Address - Zip Code:32341
Mailing Address - Country:US
Mailing Address - Phone:850-973-4853
Mailing Address - Fax:850-973-8860
Practice Address - Street 1:228 NE HANCOCK AVENUE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:FL
Practice Address - Zip Code:32340-2560
Practice Address - Country:US
Practice Address - Phone:850-973-4853
Practice Address - Fax:850-973-8860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMEOO27368207Q00000X
FLME0027368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLCG0345OtherRAILROAD MEDICARE GROUP
FL117495000Medicaid
FL256127100Medicaid
FL406082663OtherRAILROAD MEDICARE