Individual
JACK STEVEN DAUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1050 SE MONTERRY RD, STE #104, STUART, FL 34994-4512
(772) 283-2020
(772) 220-9582
Mailing address
1050 SE MONTERRY RD, STE #104, STUART, FL 34994-4512
(772) 283-2020
(772) 220-9582
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME0055247
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
062348200
—
FL
01
—
08501
BCBS OF FLORIDA
FL
01
—
08501U
MEDICARE RETIRED RAILROAD
—
01
—
08501V
MEDICARE RETIRED RAILROAD
—
Enumeration date
07/18/2005
Last updated
06/19/2012
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