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General NPI Number Information
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NPI Number | 1952724064
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Entity Type | Organization
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Legal Business Name | DONNA DYER DUBOIS DO, INC
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Dates
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Enumeration Date | 01/24/2014
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Last Update Date | 01/24/2014
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Provider Practice Location Address
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Address Line | 7006 SW WOODBINE WAY
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City | PALM CITY
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State | FL
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Zip | 34990-8332
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Country | US
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Telephone | 772-341-0001
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Fax |
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Provider Business Mailing Address
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Address Line | 7006 SW WOODBINE WAY
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City | PALM CITY
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State | FL
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Zip | 34990-8332
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Country | US
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Telephone | 772-341-0001
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DONNA DUBOIS
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Credential | DO
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Telephone | 772-941-0001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8635
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License Number State | FL
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