Provider Demographics
NPI:1295268894
Name:DOBLE, MATHEW (MD)
Entity type:Individual
Prefix:
First Name:MATHEW
Middle Name:
Last Name:DOBLE
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 1:1181 ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-4971
Mailing Address - Country:US
Mailing Address - Phone:407-647-1331
Mailing Address - Fax:407-647-2710
Practice Address - Street 1:1181 ORANGE AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-4907
Practice Address - Country:US
Practice Address - Phone:407-647-1331
Practice Address - Fax:407-647-2710
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME162122208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery