Provider Demographics
NPI:1528296050
Name:DURAN, CRISTIAN M (HSC II)
Entity type:Individual
Prefix:
First Name:CRISTIAN
Middle Name:M
Last Name:DURAN
Suffix:
Gender:M
Credentials:HSC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 W CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32805-1809
Mailing Address - Country:US
Mailing Address - Phone:407-836-2604
Mailing Address - Fax:407-836-2522
Practice Address - Street 1:832 W CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32805-1809
Practice Address - Country:US
Practice Address - Phone:407-836-2604
Practice Address - Fax:407-836-2604
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid