Provider Demographics
NPI:1548779820
Name:DUNCAN, KENROY FERNANDO
Entity Type:Individual
Prefix:
First Name:KENROY
Middle Name:FERNANDO
Last Name:DUNCAN
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 1:2901 SW 41ST ST APT 3105
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-6209
Mailing Address - Country:US
Mailing Address - Phone:646-409-6754
Mailing Address - Fax:
Practice Address - Street 1:2901 SW 41ST ST APT 3105
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-6209
Practice Address - Country:US
Practice Address - Phone:646-409-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health