Provider Demographics
NPI:1992741110
Name:DOUVILLE, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:DOUVILLE
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 1:1111 12TH ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4088
Mailing Address - Country:US
Mailing Address - Phone:305-294-8494
Mailing Address - Fax:
Practice Address - Street 1:1111 12TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4088
Practice Address - Country:US
Practice Address - Phone:305-294-8494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME30578207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79224ZMedicare PIN
FL79224Medicare ID - Type Unspecified