Healthcare Provider Details

I. General information

NPI: 1467185579
Provider Name (Legal Business Name): ELIZABETH RUBIN RCSWI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2022
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SE FEDERAL HWY STE 206
STUART FL
34994-3842
US

IV. Provider business mailing address

3617 NW 23RD TER
BOCA RATON FL
33431-5410
US

V. Phone/Fax

Practice location:
  • Phone: 772-212-2935
  • Fax:
Mailing address:
  • Phone: 561-901-6894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: