Provider Demographics
NPI:1023013679
Name:DOLBER, PAMELA S (DPM)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:S
Last Name:DOLBER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4126 LORETTO AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-1917
Mailing Address - Country:US
Mailing Address - Phone:863-385-0571
Mailing Address - Fax:
Practice Address - Street 1:3 S MAIN AVE
Practice Address - Street 2:
Practice Address - City:LAKE PLACID
Practice Address - State:FL
Practice Address - Zip Code:33852-1806
Practice Address - Country:US
Practice Address - Phone:863-699-0710
Practice Address - Fax:863-699-0710
Is Sole Proprietor?:No
Enumeration Date:2005-06-19
Last Update Date:2009-11-02
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
FLPO2842213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340365300Medicaid
CO59354208Medicaid
FLU86341Medicare UPIN
CO59354208Medicaid
FLU0233XMedicare PIN
FL340365300Medicaid