Healthcare Provider Details

I. General information

NPI: 1083654826
Provider Name (Legal Business Name): BRUCE RUBINOWICZ D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9635 SYCAMORE CT
DAVIE FL
33328-6768
US

IV. Provider business mailing address

9635 SYCAMORE CT
DAVIE FL
33328-6768
US

V. Phone/Fax

Practice location:
  • Phone: 615-300-8151
  • Fax: 786-463-1670
Mailing address:
  • Phone: 615-300-8151
  • Fax: 786-463-1670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberDO1145
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberDO1145
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number21600
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: