Provider Demographics
NPI:1225088511
Name:NABUT, JOSE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:R
Last Name:NABUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2801 W 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-1017
Mailing Address - Country:US
Mailing Address - Phone:305-805-9500
Mailing Address - Fax:305-805-9555
Practice Address - Street 1:606 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-1202
Practice Address - Country:US
Practice Address - Phone:305-545-9292
Practice Address - Fax:305-545-0579
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME44546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME44546OtherMEDICAL LICENSE