Provider Demographics
NPI:1356503635
Name:ROLLINS DUBOIS HEALTH CENTER
Entity Type:Organization
Organization Name:ROLLINS DUBOIS HEALTH CENTER
Other - Org Name:ROLLINS COLLEGE DUBOIS HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR HEALTH CENTER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:RUBY
Authorized Official - Last Name:WEISSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:407-646-2235
Mailing Address - Street 1:1000 HOLT AVE
Mailing Address - Street 2:2727
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4499
Mailing Address - Country:US
Mailing Address - Phone:407-646-2235
Mailing Address - Fax:407-646-2213
Practice Address - Street 1:1000 HOLT AVE
Practice Address - Street 2:2727
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4499
Practice Address - Country:US
Practice Address - Phone:407-646-2235
Practice Address - Fax:407-646-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health