Provider Demographics
NPI:1134159700
Name:DUARA, RANJAN (MD)
Entity type:Individual
Prefix:DR
First Name:RANJAN
Middle Name:
Last Name:DUARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 ALTON ROAD
Mailing Address - Street 2:WEIN CENTER
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140
Mailing Address - Country:US
Mailing Address - Phone:305-674-2543
Mailing Address - Fax:305-674-2996
Practice Address - Street 1:4300 ALTON ROAD
Practice Address - Street 2:WEIN CENTER
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140
Practice Address - Country:US
Practice Address - Phone:305-674-2543
Practice Address - Fax:305-674-2996
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME446692084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL046113000Medicaid
022662Medicare ID - Type Unspecified
FL046113000Medicaid