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General NPI Number Information
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NPI Number | 1093888190
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Entity Type | Organization
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Legal Business Name | JORGE DUBOIS, M.D., P.A.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 845 E 10TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4645
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Country | US
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Telephone | 305-310-3587
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Fax |
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Provider Business Mailing Address
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Address Line | 845 E 10TH AVE
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City | HIALEAH
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State | FL
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Zip | 33010-4645
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JORGE DUBOIS
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Credential |
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Telephone | 305-310-3587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number | ME 92151
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License Number State | FL
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