Individual
DR. NILESH V DUBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 HICKORY ST STE A, MELBOURNE, FL 32901-1973
(321) 409-1956
(321) 409-1253
Mailing address
3300 S FISKE BLVD STE 605, ROCKLEDGE, FL 32955-4306
(321) 409-1956
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
ME159596
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117331000
—
FL
05
—
3889572
—
TN
01
—
QK112
MEDICARE HF
FL
Enumeration date
05/31/2005
Last updated
11/03/2023
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