Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CH0004717 | FL |
NPI | 1457534638 |
---|---|
Provider Name | Brenda K Dukes |
First Address | Plant City, FL 33566-7172 |
Second Address | Plant City, FL 33566-7172 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2007 |
Last Update Date | 11/12/2007 |