Provider Demographics
NPI:1134430192
Name:DUENAS, VINCENT (DO)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:DUENAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 LAKEVIEW DRIVE
Mailing Address - Street 2:PAGO BAY RESORT
Mailing Address - City:YONA
Mailing Address - State:GU
Mailing Address - Zip Code:96915
Mailing Address - Country:US
Mailing Address - Phone:671-689-4219
Mailing Address - Fax:
Practice Address - Street 1:280 PALE SAN VITORES RD APT 104
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3651
Practice Address - Country:US
Practice Address - Phone:671-689-4219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUDO-54207R00000X, 207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUH109383Medicare Oscar/Certification