Provider Demographics
NPI:1306036850
Name:UBHRANI, DOLLY (MD)
Entity Type:Individual
Prefix:
First Name:DOLLY
Middle Name:
Last Name:UBHRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1385 W STATE ROAD 434
Mailing Address - Street 2:STE 206
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-6871
Mailing Address - Country:US
Mailing Address - Phone:407-644-9970
Mailing Address - Fax:407-644-6926
Practice Address - Street 1:1385 W STATE ROAD 434
Practice Address - Street 2:STE 206
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-6871
Practice Address - Country:US
Practice Address - Phone:407-644-9970
Practice Address - Fax:407-644-6926
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME107927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL003040200Medicaid