Provider Demographics
NPI:1932931144
Name:EUGENE, DUKE
Entity type:Individual
Prefix:
First Name:DUKE
Middle Name:
Last Name:EUGENE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7605 SW 10TH ST APT A-1
Mailing Address - Street 2:
Mailing Address - City:NORTH LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33068-3390
Mailing Address - Country:US
Mailing Address - Phone:954-638-1528
Mailing Address - Fax:
Practice Address - Street 1:7605 SW 10TH ST APT A-1
Practice Address - Street 2:
Practice Address - City:NORTH LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33068-3390
Practice Address - Country:US
Practice Address - Phone:954-638-1528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant