Provider Demographics
NPI:1508012923
Name:MONINA A DURAN MD PA
Entity Type:Organization
Organization Name:MONINA A DURAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONINA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-793-0815
Mailing Address - Street 1:918 MARGINAL RD
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-5418
Mailing Address - Country:US
Mailing Address - Phone:561-793-0815
Mailing Address - Fax:561-793-1839
Practice Address - Street 1:918 MARGINAL RD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-5418
Practice Address - Country:US
Practice Address - Phone:561-793-0815
Practice Address - Fax:561-793-1839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1808Medicare PIN