MEDICARE: DR. LAWRENCE BENJAMIN RUBIN DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO421	FL

General Provider Information

NPI Number	:	1285644013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAWRENCE BENJAMIN RUBIN DPM

Provider Business Mailing Address
First Line	:	17158 NE 19TH AVE
Second Line	:	DR LAWRENCE B RUBIN
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162
Country	:	US
Telephone Number	:	305-940-3114
Fax Number	:

Provider Business Practice Location Address
First Line	:	17158 NE 19TH AVE
Second Line	:	DR LAWRENCE B RUBIN
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33162-3102
Country	:	US
Telephone Number	:	305-940-3114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	07/08/2007

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