Healthcare Provider Details

I. General information

NPI: 1255445524
Provider Name (Legal Business Name): JANE ELOISE RUBINOV R.R.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11873 NW 28TH ST
CORAL SPRINGS FL
33065-3313
US

IV. Provider business mailing address

11873 NW 28TH ST
CORAL SPRINGS FL
33065-3313
US

V. Phone/Fax

Practice location:
  • Phone: 954-255-9189
  • Fax:
Mailing address:
  • Phone: 954-255-9189
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRT 1495
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: