Provider Demographics
NPI:1265561823
Name:DUBOY, EMILIO (MD)
Entity type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:DUBOY
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 1:2051 45TH ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407
Mailing Address - Country:US
Mailing Address - Phone:561-840-1480
Mailing Address - Fax:561-840-1482
Practice Address - Street 1:2051 45TH ST
Practice Address - Street 2:SUITE 209
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407
Practice Address - Country:US
Practice Address - Phone:561-840-1480
Practice Address - Fax:561-840-1482
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00754812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255791600Medicaid
F20393Medicare UPIN
FL255791600Medicaid