1932351178 NPI number — JERRY A RUBIN MD

Table of content: (NPI 1932351178)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932351178 NPI number — JERRY A RUBIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JERRY A RUBIN MD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CENTRAL FLORIDA HAND SPECIALISTS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932351178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6900 TURKEY LAKE RD
Provider Second Line Business Mailing Address:
SUITE 1-7
Provider Business Mailing Address City Name:
ORLANDO
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32819-4707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
321-939-3300
Provider Business Mailing Address Fax Number:
321-939-3303

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6900 TURKEY LAKE RD
Provider Second Line Business Practice Location Address:
SUITE 1-7
Provider Business Practice Location Address City Name:
ORLANDO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32819-4707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
321-939-3300
Provider Business Practice Location Address Fax Number:
321-939-3303
Provider Enumeration Date:
10/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RUBIN
Authorized Official First Name:
JERRY
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
321-939-3300

Provider Taxonomy Codes

  • Taxonomy code: 207XS0106X , with the licence number:  ME66320 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2082S0105X , with the licence number: ME66320 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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