MEDICARE: MS. ELENA MARIA RUBIO M.S. CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SA 7187	FL

General Provider Information

NPI Number	:	1760584262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELENA MARIA RUBIO M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	1300 DAYTONIA RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-1727
Country	:	US
Telephone Number	:	305-864-4583
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 DAYTONIA RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33141-1727
Country	:	US
Telephone Number	:	305-864-4583
Fax Number	:

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

Provider Enumeration Date	:	09/04/2006
Last Update Date	:	07/09/2007

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