Provider Demographics
NPI:1750680989
Name:DUREN, CANDICE L (DPT)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:L
Last Name:DUREN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 AIRPORT BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-5931
Mailing Address - Country:US
Mailing Address - Phone:850-477-6966
Mailing Address - Fax:850-477-0267
Practice Address - Street 1:7581 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5939
Practice Address - Country:US
Practice Address - Phone:850-453-9475
Practice Address - Fax:850-453-9673
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL26295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist