Provider Demographics
NPI:1073532735
Name:DOBLEO, DOROTHY ERIN (OD)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:ERIN
Last Name:DOBLEO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9397 SAN JOSE BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-5587
Mailing Address - Country:US
Mailing Address - Phone:904-730-2299
Mailing Address - Fax:904-730-2557
Practice Address - Street 1:9397 SAN JOSE BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5587
Practice Address - Country:US
Practice Address - Phone:904-730-2299
Practice Address - Fax:904-730-2557
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 4092152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000967900Medicaid
FL1900ZOtherBCBS
FL1900ZOtherBCBS
FLAM785ZMedicare PIN