MEDICARE: EVAN RUBENSTEEN DMD 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1891546578
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVAN RUBENSTEEN DMD PA

Provider Business Mailing Address
First Line	:	939 ARTHUR GODFREY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3306
Country	:	US
Telephone Number	:	305-672-2260
Fax Number	:	206-600-6861

Provider Business Practice Location Address
First Line	:	939 ARTHUR GODFREY RD
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-3306
Country	:	US
Telephone Number	:	305-672-2260
Fax Number	:	206-600-6861

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	EVAN RUBENSTEEN
Credential	:	DMD
Telephone Number	:	305-672-2260

Provider Enumeration Date	:	03/29/2024
Last Update Date	:	03/29/2024

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