Provider Demographics
NPI:1912283342
Name:DUBOCK, RONALD GEORGE JR (PAC)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:GEORGE
Last Name:DUBOCK
Suffix:JR
Gender:M
Credentials:PAC
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Mailing Address - Street 1:1974 FAIRMONT LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-4571
Mailing Address - Country:US
Mailing Address - Phone:239-300-1304
Mailing Address - Fax:
Practice Address - Street 1:1284 CREEKSIDE ST STE 105
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1949
Practice Address - Country:US
Practice Address - Phone:239-591-1488
Practice Address - Fax:239-591-2491
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2024-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9106263363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant