Healthcare Provider Details

I. General information

NPI: 1275373805
Provider Name (Legal Business Name): ROBERTO O DUBARRY II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2024
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 IRVING ST NW
WASHINGTON DC
20010-2921
US

IV. Provider business mailing address

701 2ND ST NE APT 247
WASHINGTON DC
20002-5057
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-1566
  • Fax:
Mailing address:
  • Phone: 305-776-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: