Healthcare Provider Details

I. General information

NPI: 1326216979
Provider Name (Legal Business Name): DAVID LUBIN PHD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2008
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 SAWGRASS CORPORATE PKWY
SUNRISE FL
33325-6244
US

IV. Provider business mailing address

381 SW 190TH AVE
PEMBROKE PINES FL
33029-5443
US

V. Phone/Fax

Practice location:
  • Phone: 954-745-1112
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID LUBIN
Title or Position: PRESIDENT
Credential: PH.D., BCBA
Phone: 954-560-4401