Provider Demographics
NPI:1235267857
Name:DUBOIS MEDICAL CENTER INC
Entity Type:Organization
Organization Name:DUBOIS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-643-4177
Mailing Address - Street 1:434 SW 12TH AVE STE 402
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-2434
Mailing Address - Country:US
Mailing Address - Phone:305-643-4177
Mailing Address - Fax:305-643-0175
Practice Address - Street 1:434 SW 12TH AVE STE 402
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33130-2434
Practice Address - Country:US
Practice Address - Phone:305-643-4177
Practice Address - Fax:305-643-0175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center