Provider Demographics
NPI:1770016826
Name:DUBIN, TARYN L (MD)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:L
Last Name:DUBIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 SW 62ND PL PH WEST5TH
Mailing Address - Street 2:
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-4800
Mailing Address - Country:US
Mailing Address - Phone:305-661-1962
Mailing Address - Fax:
Practice Address - Street 1:7300 SW 62ND PL PH WEST5TH
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-4800
Practice Address - Country:US
Practice Address - Phone:305-661-1962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158751208000000X
FL152678208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics