Healthcare Provider Details

I. General information

NPI: 1548259070
Provider Name (Legal Business Name): JONATHAN SCOTT RUBIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 N STATE ROAD 7 SUITE 205
MARGATE FL
33063-5737
US

IV. Provider business mailing address

6535 NW 95TH LN
PARKLAND FL
33076-2313
US

V. Phone/Fax

Practice location:
  • Phone: 954-979-3292
  • Fax: 954-970-4308
Mailing address:
  • Phone: 954-979-3292
  • Fax: 954-970-4308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME59741
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License NumberME59741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: