Provider Demographics
NPI:1558520999
Name:DUNCAN, NADINE ROSEMARIE
Entity Type:Individual
Prefix:MISS
First Name:NADINE
Middle Name:ROSEMARIE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16425 SW 103RD CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3148
Mailing Address - Country:US
Mailing Address - Phone:786-942-2217
Mailing Address - Fax:
Practice Address - Street 1:30342 OLD DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3215
Practice Address - Country:US
Practice Address - Phone:305-246-3828
Practice Address - Fax:305-246-3829
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21153225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant