Provider Demographics
NPI:1295709210
Name:DURNEY, PAUL C (DPM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:C
Last Name:DURNEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 MCCRORY PL
Mailing Address - Street 2:STE 174
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3727
Mailing Address - Country:US
Mailing Address - Phone:407-423-1234
Mailing Address - Fax:407-517-1040
Practice Address - Street 1:1601 S APOLLO BLVD
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-4484
Practice Address - Country:US
Practice Address - Phone:321-952-1234
Practice Address - Fax:321-676-9199
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 1575213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL390123800Medicaid
FLP00112207OtherR/R MEDICARE
FLP00112207OtherR/R MEDICARE
FLT29834Medicare UPIN