Provider Demographics
NPI:1629381637
Name:DOBRONSKI JACOME, LEOPOLDO ALBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:LEOPOLDO
Middle Name:ALBERTO
Last Name:DOBRONSKI JACOME
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 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:5 W MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-4215
Practice Address - Country:US
Practice Address - Phone:864-522-5220
Practice Address - Fax:864-522-5309
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101257874207R00000X
SC86848207R00000X
TXBP1-0037292390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program