Healthcare Provider Details

I. General information

NPI: 1790361582
Provider Name (Legal Business Name): ROSS STUBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PALM BEACH LAKES BLVD
WEST PALM BEACH FL
33409-6503
US

IV. Provider business mailing address

2000 PALM BEACH LAKES BLVD
WEST PALM BEACH FL
33409-6503
US

V. Phone/Fax

Practice location:
  • Phone: 561-500-2020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberME179870
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: