Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | ME66879 | FL |
Y | 207RX0202X | Medical Oncology | ME66879 | FL |
NPI | 1033192570 |
---|---|
Provider Name | Dr. Mark S. Rubin |
First Address | Fort Myers, FL 33916-2216 |
Second Address | Bonita Springs, FL 34135-4773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
376392700 | (05) | FL |
830004845 | RR MEDICARE (01) | FL |
F90057 | (02) | FL |