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NPI Code Detail

MEDICARE: PREETI DUBE M.D

MEDICARE: PREETI DUBE M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician0213001770VA
2390200000XStudent in an Organized Health Care Education/Training Program
3207RC0000XCardiovascular Disease Physician0101251782VA

General Provider Information

NPI Number : 1376709980
Entity Type Code : Individual
Provider Name (Legal Business Name) : PREETI DUBE M.D
Provider Business Mailing Address
First Line : 1395 NW 167TH ST
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33169-5710
Country : US
Telephone Number : 305-628-6117
Fax Number :
Provider Business Practice Location Address
First Line : 524 SOUTHPARK BLVD
Second Line :
City : COLONIAL HEIGHTS
State : VA
Zip : 23834-3609
Country : US
Telephone Number : 804-504-7980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2008
Last Update Date : 03/25/2020

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