Healthcare Provider Details

I. General information

NPI: 1891785515
Provider Name (Legal Business Name): STEWART M DOBBINS II MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 INGRAHAM AVE
HAINES CITY FL
33844-4336
US

IV. Provider business mailing address

900 INGRAHAM AVE
HAINES CITY FL
33844-4336
US

V. Phone/Fax

Practice location:
  • Phone: 638-421-6565
  • Fax: 863-421-7474
Mailing address:
  • Phone: 863-421-6565
  • Fax: 863-421-7474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME69272
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: