Provider Demographics
NPI:1679767735
Name:DURGIN, MANAL SOLIMAN (MD)
Entity type:Individual
Prefix:DR
First Name:MANAL
Middle Name:SOLIMAN
Last Name:DURGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 DEVEREUX DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7907
Mailing Address - Country:US
Mailing Address - Phone:321-242-9100
Mailing Address - Fax:321-259-0786
Practice Address - Street 1:8000 DEVEREUX DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7907
Practice Address - Country:US
Practice Address - Phone:321-242-9100
Practice Address - Fax:321-259-0786
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00710152084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252117200Medicaid
31571OtherMEDICARE PROVIDER #
FLG32375OtherUPIN