Healthcare Provider Details

I. General information

NPI: 1184648495
Provider Name (Legal Business Name): BARRY F DOBIES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 09/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PLANTATION ISLAND DR S SUITE 104A
ST AUGUSTINE FL
32080-3109
US

IV. Provider business mailing address

1301 PLANTATION ISLAND DR S SUITE 104A
ST AUGUSTINE FL
32080-3109
US

V. Phone/Fax

Practice location:
  • Phone: 904-471-4441
  • Fax: 904-471-4489
Mailing address:
  • Phone: 904-471-4441
  • Fax: 904-471-4489

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME63544
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: