Individual
MRS. ANDREA DEPTULA DUANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
969 SE CENTRAL PKWY, STUART, FL 34994-3904
(772) 283-0109
(772) 283-1948
Mailing address
969 SE CENTRAL PKWY, STUART, FL 34994-3904
(772) 283-0109
(772) 283-1948
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9104216
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA9104216
STATE LICENSE #
FL
Enumeration date
06/23/2010
Last updated
03/08/2019
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