Provider Demographics
NPI:1922077437
Name:DURU, IVORIQUE' CLARK (DO)
Entity type:Individual
Prefix:DR
First Name:IVORIQUE'
Middle Name:CLARK
Last Name:DURU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:IVORIQUE'
Other - Middle Name:ORENNA
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:73 SPRING TIDE WAY
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA
Mailing Address - State:FL
Mailing Address - Zip Code:32081-4416
Mailing Address - Country:US
Mailing Address - Phone:619-578-3763
Mailing Address - Fax:
Practice Address - Street 1:2104 MASSEY AVENUE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32228
Practice Address - Country:US
Practice Address - Phone:904-270-4319
Practice Address - Fax:904-270-4451
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9515207Q00000X
GA067099207Q00000X
FLOS14611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine