HERMAN M. DUPERAULT JR. O.D. P.A. NPI 1710900824

NPI Information

NPI: 1710900824
Provider Name: HERMAN M. DUPERAULT, JR., O.D., P.A.

Other Name: H.M. DUPERAULT JR. O.D. P.A.

Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
447 ATLANTIC BLVD
SUITE 1
ATLANTIC BEACH, FL
ZIP 32233
Phone: (904) 246-4372
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HERMAN M. DUPERAULT, JR., O.D., P.A. is a point of service in Atlantic Beach, FL. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. HERMAN M. DUPERAULT, JR., O.D., P.A. NPI is 1710900824. The provider is registered as an organization entity type.
The provider Other Name Is H.m. Duperault Jr. O.d. P.a..

The provider's business location address is:

447 ATLANTIC BLVD
SUITE 1
ATLANTIC BEACH, FL
ZIP 32233-004
Phone: (904) 246-4372
Fax: (904) 246-6115

The provider's authorized official is Herman M Duperault .
The authorized official title is President and has the following contact phone number (904) 246-0404.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 6/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	305S00000X	Point of Service		OPC 672	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	084332600	MEDICAID	FLORIDA
2	19228	MEDICARE ID-TYPE UNSPECIFIED	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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