Provider Demographics
NPI:1306899893
Name:DOBKIN, STEPHEN F (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:F
Last Name:DOBKIN
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 1:258 S CHICKASAW TRL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-3501
Mailing Address - Country:US
Mailing Address - Phone:407-303-6865
Mailing Address - Fax:407-303-6537
Practice Address - Street 1:258 S CHICKASAW TRL
Practice Address - Street 2:SUITE 200
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-3501
Practice Address - Country:US
Practice Address - Phone:407-303-6865
Practice Address - Fax:407-303-6537
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME93187208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272853200Medicaid
FL07757OtherBCBS
P00322912OtherRAILROAD MEDICARE
P00322912OtherRAILROAD MEDICARE
E45641Medicare UPIN