Individual provider Active NPI

Clifford B Dubbin, MD

  • Otolaryngology Physician
  • Orlando, FL
National Provider Identifier
1245209352
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
ME35376 Issued in FL
Practice address
1781 Park Center Drive
Suite 210
Orlando, FL 32835
Phone
(407) 351-0675
Fax
(407) 352-1867
NPI assigned
Mar 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X ME35376 FL Primary

Addresses

Primary practice location

1781 Park Center Drive
Suite 210
Orlando, FL 32835

Mailing address

7251 University Blvd
Suite 300
Winter Park, FL 32792
Phone (407) 677-0099

Other identifiers 1

IdentifierTypeStateIssuer
067409500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100212000582 FL Practitioner - Otolaryngology 8426192568 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME35376FLMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Otolaryngology Group, P.a. Otolaryngology CurrentSince Oct 9, 1979 Accepting new patients

Locations

5979 Vineland Rd
Ste 101
Orlando, FL 32819
Phone (407) 355-3120

1781 Park Center Dr
Ste 210
Orlando, FL 32835
Phone (407) 351-0675

7251 University Blvd
Ste 300
Winter Park, FL 32792
Phone (407) 677-0099

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245209352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7251 UNIVERSITY BLVD",
            "address_2": "SUITE 300",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "32792",
            "telephone_number": "407-677-0099",
            "fax_number": "407-677-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1781 PARK CENTER DRIVE",
            "address_2": "SUITE 210",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "32835",
            "telephone_number": "407-351-0675",
            "fax_number": "407-352-1867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBBIN",
        "first_name": "CLIFFORD",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME35376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "067409500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.