Provider Demographics
NPI:1548335813
Name:DURAN, DRIANIS (AUD)
Entity type:Individual
Prefix:DR
First Name:DRIANIS
Middle Name:
Last Name:DURAN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:DRIANIS
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:8900 GLADIOLUS DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4487
Mailing Address - Country:US
Mailing Address - Phone:239-267-7888
Mailing Address - Fax:239-267-0409
Practice Address - Street 1:8900 GLADIOLUS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4487
Practice Address - Country:US
Practice Address - Phone:239-267-7888
Practice Address - Fax:239-267-0409
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1164231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL600507100Medicaid
0140162OtherGHI
1548335813OtherTRICARE
01088308OtherAMERIGROUP
FLS9326OtherBCBS
FL600507100Medicaid