Provider Demographics
NPI:1609839182
Name:DUBNER, BARRY HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:HERBERT
Last Name:DUBNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3000 N UNIVERSITY DR
Mailing Address - Street 2:SUITE K
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-5055
Mailing Address - Country:US
Mailing Address - Phone:954-752-2630
Mailing Address - Fax:954-752-9391
Practice Address - Street 1:3000 N UNIVERSITY DR
Practice Address - Street 2:SUITE K
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-5055
Practice Address - Country:US
Practice Address - Phone:954-752-2630
Practice Address - Fax:954-752-9391
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME52062207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL206586OtherAVMED
FL04073019OtherAETNA
FLO7068OtherBCBS
FL070003808OtherMEDICARE RAILROAD
FL524965OtherUNITED
FL0056952OtherGHI
D21147Medicare UPIN
FL0056952OtherGHI