Provider Demographics
NPI:1730138983
Name:WALBEY, DOROTHY (DPM)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:WALBEY
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11144 APPLE BLOSSOM TRL W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-7355
Mailing Address - Country:US
Mailing Address - Phone:904-982-8841
Mailing Address - Fax:904-766-7414
Practice Address - Street 1:2255 DUNN AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-4719
Practice Address - Country:US
Practice Address - Phone:904-982-8841
Practice Address - Fax:904-766-7414
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-08
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3102213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL340577000Medicaid