Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | ME42777 | FL |
NPI | 1649294448 |
---|---|
Provider Name | Jay J Rubin |
First Address | Ocala, FL 34474-7163 |
Second Address | Ocala, FL 34474-7163 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 24/09/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043192300 | (05) | FL |
D56673 | (02) | FL |