MEDICARE: ANITE LUBIN MD PA

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	207R00000X	Internal Medicine Physician		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366536559
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANITE LUBIN MD PA

Provider Business Mailing Address
First Line	:	4724 MONROE STREET
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021
Country	:	US
Telephone Number	:	305-981-4700
Fax Number	:	305-981-2600

Provider Business Practice Location Address
First Line	:	1073 NE 125TH STREET
Second Line	:
City	:	N MIAMI
State	:	FL
Zip	:	33161
Country	:	US
Telephone Number	:	305-787-5909
Fax Number	:	305-981-2600

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANITE M LUBIN
Credential	:	MD
Telephone Number	:	305-787-5909

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	08/22/2020

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Directions to “ANITE LUBIN MD PA ” Practice Location

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