Healthcare Provider Details

I. General information

NPI: 1275722753
Provider Name (Legal Business Name): RUB PEDIATRICS MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2007
Last Update Date: 02/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1190 NW 95TH ST SUITE 409
MIAMI FL
33150-2063
US

IV. Provider business mailing address

21110 BISCAYNE BLVD SUITE 308
AVENTURA FL
33180-1227
US

V. Phone/Fax

Practice location:
  • Phone: 305-696-9490
  • Fax: 305-696-6225
Mailing address:
  • Phone: 305-932-1007
  • Fax: 305-696-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME55002
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME54702
License Number StateFL

VIII. Authorized Official

Name: JANET NEUSCHATZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 305-932-1007