Healthcare Provider Details

I. General information

NPI: 1689617367
Provider Name (Legal Business Name): SANDER R DUBOVY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NW 17TH AVE
MIAMI FL
33101-6960
US

IV. Provider business mailing address

PO BOX 16960
MIAMI FL
33101-6960
US

V. Phone/Fax

Practice location:
  • Phone: 305-326-6031
  • Fax: 305-243-8470
Mailing address:
  • Phone: 305-326-6031
  • Fax: 305-243-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME81583
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberME81583
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License NumberME81583
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: