Provider Demographics
NPI:1699573626
Name:DURAN, JANE DUPRA
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:DUPRA
Last Name:DURAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12124 NW 46TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2230
Mailing Address - Country:US
Mailing Address - Phone:305-336-9748
Mailing Address - Fax:
Practice Address - Street 1:4800 W HILLSBORO BLVD STE A6
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4330
Practice Address - Country:US
Practice Address - Phone:305-336-9748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily