Healthcare Provider Details

I. General information

NPI: 1801677430
Provider Name (Legal Business Name): MELANIA RENATA RUBIANO PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2023
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 W SAMPLE RD
POMPANO BEACH FL
33073-3081
US

IV. Provider business mailing address

2112 S CYPRESS BEND DR APT 402
POMPANO BEACH FL
33069-4452
US

V. Phone/Fax

Practice location:
  • Phone: 833-422-5585
  • Fax:
Mailing address:
  • Phone: 954-330-6652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11029067
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: