Healthcare Provider Details

I. General information

NPI: 1710151618
Provider Name (Legal Business Name): ROY MINOO DUBASH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1740 SHERIDAN ST
HOLLYWOOD FL
33020-2275
US

IV. Provider business mailing address

2900 CORPORATE WAY # D
MIRAMAR FL
33025-3925
US

V. Phone/Fax

Practice location:
  • Phone: 954-276-1565
  • Fax: 954-927-0945
Mailing address:
  • Phone: 954-276-5685
  • Fax: 954-985-7074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR1183
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: