Individual
DR. GUSTAVO DURAZO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
1100 N F AVE, DOUGLAS, AZ 85607-1919
(520) 364-3285
(520) 364-4261
Mailing address
1205 N F AVE, DOUGLAS, AZ 85607-1920
(520) 364-6852
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
229416
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
583256
—
AZ
Enumeration date
07/16/2019
Last updated
11/15/2019
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