Healthcare Provider Details

I. General information

NPI: 1225532625
Provider Name (Legal Business Name): PABLO GABRIEL DUBON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2018
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S OSPREY AVE
SARASOTA FL
34239-2938
US

IV. Provider business mailing address

119 OAKFIELD DR
BRANDON FL
33511-5779
US

V. Phone/Fax

Practice location:
  • Phone: 413-669-0609
  • Fax: 813-916-2944
Mailing address:
  • Phone: 813-681-5551
  • Fax: 813-916-2944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberME155747
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: