Provider Demographics
NPI:1396372579
Name:DUBARRY, ERIK LUIS
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:LUIS
Last Name:DUBARRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 SUSAN B BRITT CT STE 250
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-1905
Mailing Address - Country:US
Mailing Address - Phone:954-294-0892
Mailing Address - Fax:
Practice Address - Street 1:530 SUSAN B BRITT CT STE 250
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-1905
Practice Address - Country:US
Practice Address - Phone:954-294-0892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2020-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLD160212844571172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver