Provider Demographics
NPI:1437213873
Name:DUBINSKY, SUSAN (PA-C)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:
Last Name:DUBINSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 NW 25TH TER
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-5117
Mailing Address - Country:US
Mailing Address - Phone:352-955-5893
Mailing Address - Fax:352-373-5326
Practice Address - Street 1:1621 NE WALDO RD
Practice Address - Street 2:TACACHALE MEDICAL SERVICES
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32609-3900
Practice Address - Country:US
Practice Address - Phone:352-955-5893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA003467363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA003467OtherFLORIDA LISC. NUMBER
FLPA003467OtherFLORIDA LISC. NUMBER