Provider Demographics
NPI:1275539389
Name:DOBEN, STEPHEN M (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:DOBEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:299 CAMINO GARDENS BLVD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-5822
Mailing Address - Country:US
Mailing Address - Phone:561-395-9299
Mailing Address - Fax:561-395-7995
Practice Address - Street 1:299 CAMINO GARDENS BLVD
Practice Address - Street 2:SUITE 103
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5822
Practice Address - Country:US
Practice Address - Phone:561-395-9299
Practice Address - Fax:561-395-7995
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME37335208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
E14554Medicare UPIN
FL93982DMedicare PIN