Provider Demographics
NPI:1275923377
Name:EMILIO J DUBOY, MD
Entity Type:Organization
Organization Name:EMILIO J DUBOY, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:COREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBOY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-840-1480
Mailing Address - Street 1:2051 45TH ST STE 209
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2014
Mailing Address - Country:US
Mailing Address - Phone:561-840-1480
Mailing Address - Fax:561-840-1482
Practice Address - Street 1:2051 45TH ST STE 209
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2014
Practice Address - Country:US
Practice Address - Phone:561-840-1480
Practice Address - Fax:561-840-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00754812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL25579160Medicaid
FLE2079AMedicare UPIN