Healthcare Provider Details

I. General information

NPI: 1356503635
Provider Name (Legal Business Name): ROLLINS DUBOIS HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HOLT AVE 2727
WINTER PARK FL
32789-4499
US

IV. Provider business mailing address

1000 HOLT AVE 2727
WINTER PARK FL
32789-4499
US

V. Phone/Fax

Practice location:
  • Phone: 407-646-2235
  • Fax: 407-646-2213
Mailing address:
  • Phone: 407-646-2235
  • Fax: 407-646-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. SANDRA RUBY WEISSTEIN
Title or Position: DIRECTOR HEALTH CENTER
Credential: FNP-BC
Phone: 407-646-2235