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General NPI Number Information
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NPI Number | 1275658809
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Entity Type | Individual
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Provider Name | MARY-JO RUBIN M.A., P.T., A.P.
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Gender | Female
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 09/07/2011
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Provider Practice Location Address
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Address Line | 8645 N MILITARY TRL SUITE 401
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City | WEST PALM BEACH
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State | FL
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Zip | 33410-6294
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Country | US
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Telephone | 561-776-7170
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Fax | 561-776-7171
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Provider Business Mailing Address
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Address Line | 10803 WHARTON WAY
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City | WEST PALM BEACH
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State | FL
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Zip | 33412-1113
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Country | US
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Telephone | 561-776-7170
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Fax | 561-776-7171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 95
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2048
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License Number State | FL
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