MEDICARE: BARBARA A. LUBIN MD

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	207Q00000X	Family Medicine Physician	ME52928	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05877	OTHER	FL	BCBS OF FLORIDA

General Provider Information

NPI Number	:	1629007885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA A. LUBIN MD

Provider Business Mailing Address
First Line	:	1124 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2439
Country	:	US
Telephone Number	:	850-785-8246
Fax Number	:

Provider Business Practice Location Address
First Line	:	1124 JENKS AVE
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32401-2439
Country	:	US
Telephone Number	:	850-785-8246
Fax Number	:	850-785-8249

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

Provider Enumeration Date	:	07/01/2006
Last Update Date	:	05/13/2024

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