Healthcare Provider Details

I. General information

NPI: 1407483712
Provider Name (Legal Business Name): AYAT AL RUBAYE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 VAN DYKE RD STE 200
LUTZ FL
33558-8005
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 813-870-4933
  • Fax:
Mailing address:
  • Phone: 727-281-9065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number160408
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: