MEDICARE: BRENT L. RUBIN & ASSOCIATES INC

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

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

General Provider Information

NPI Number	:	1922031400
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRENT L. RUBIN & ASSOCIATES INC

Provider Business Mailing Address
First Line	:	3055 W SYLVANIA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-4135
Country	:	US
Telephone Number	:	419-473-0125
Fax Number	:	419-473-1230

Provider Business Practice Location Address
First Line	:	3055 W SYLVANIA AVE
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43613-4135
Country	:	US
Telephone Number	:	419-473-0125
Fax Number	:	419-473-1230

Authorized Official
Title or Position	:	PODIATRIST/OWNER
Name	:	MICHAEL WALKOVICH
Credential	:	DPM
Telephone Number	:	419-473-0125

Provider Enumeration Date	:	07/08/2006
Last Update Date	:	05/30/2023

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