Provider Demographics
NPI:1588656714
Name:DUBIN, ANDREW HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HOWARD
Last Name:DUBIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 HULL RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4144
Mailing Address - Country:US
Mailing Address - Phone:352-273-7375
Mailing Address - Fax:352-273-7388
Practice Address - Street 1:3450 HULL RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4144
Practice Address - Country:US
Practice Address - Phone:352-273-7375
Practice Address - Fax:352-273-7388
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183234208100000X
FLME141036208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01208460Medicaid
FL104301600Medicaid
NY52466DMedicare ID - Type Unspecified