Healthcare Provider Details
I. General information
NPI: 1194861211
Provider Name (Legal Business Name): DK PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2007
Last Update Date: 06/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2230 ASHLEY OAKS CIR STE 102
WESLEY CHAPEL FL
33544-6429
US
IV. Provider business mailing address
2230 ASHLEY OAKS CIR STE 102
WESLEY CHAPEL FL
33544-6429
US
V. Phone/Fax
- Phone: 813-973-2500
- Fax: 813-973-4438
- Phone: 813-973-2500
- Fax: 813-973-4438
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
RITA
DUBEY
Title or Position: PRESIDENT
Credential: M.D
Phone: 813-973-2500