Johana F Duque, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9105593 Issued in FL

Practice address

4850 W Oakland Park Blvd
201
Lauderdale Lakes, FL 33313-7260

Phone

(954) 735-3535

Fax

(954) 735-7908

NPI assigned

Nov 29, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Total Orthopaedic Care PA

  • Orthopaedic Surgery Physician
  • Lauderdale Lakes, FL
  • NPI 1558317545
  Medicare reassignment
• Total Orthopaedic Care, P.a.

  • Orthopaedic Surgery Physician
  • Pembroke Pines, FL
  • NPI 1861708570
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468972800000",
    "number": "1497057350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "address_2": "201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "954-735-3535",
            "fax_number": "954-735-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 W OAKLAND PARK BLVD",
            "address_2": "201",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333137260",
            "telephone_number": "954-735-3535",
            "fax_number": "954-735-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUQUE",
        "first_name": "JOHANA",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-29",
        "last_updated": "2016-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9105593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009196800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• DRS. Cukierman & Gomez, Inc (Advanced Vision)
• Dsa Therapy & Health Services
• Dse Health Systems, Inc.
• Moody Dubreuze
• Idatude Merdelus Dumay
• Michaelange Durant, M.S.
• Rose Marie Cecile Dyer, LPN
• Easy Care Home Agency LLC
• Eb Land Investment LLC (health plus sunrise medical office)
• Sofia Echevarria Vorobiova

• Medical Physician Assistant in Lauderdale Lakes, FL
• Providers in Lauderdale Lakes, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.