Healthcare Provider Details

I. General information

NPI: 1033391768
Provider Name (Legal Business Name): MARK P RUBINO MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2007
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 RIDGE ST
NAPLES FL
34103-4211
US

IV. Provider business mailing address

848 1ST AVE N STE 340
NAPLES FL
34102-6063
US

V. Phone/Fax

Practice location:
  • Phone: 239-261-6876
  • Fax: 239-643-4969
Mailing address:
  • Phone: 239-261-6876
  • Fax: 239-643-4969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME75629
License Number StateFL

VIII. Authorized Official

Name: MARK P RUBINO
Title or Position: PRESIDENT/ OWNER
Credential: MD
Phone: 239-261-6876