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General NPI Number Information
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NPI Number | 1316367196
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Entity Type | Individual
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Provider Name | GREGORY BRAD RUBIN DO
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Gender | Male
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Dates
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Enumeration Date | 04/21/2014
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 1250 PINE RIDGE RD STE 202
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City | NAPLES
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State | FL
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Zip | 34108-8913
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Country | US
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Telephone | 239-325-1135
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Fax | 239-325-1205
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Provider Business Mailing Address
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Address Line | 3451 PINE RIDGE RD BLDG 601
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City | NAPLES
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State | FL
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Zip | 34109-3922
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Country | US
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Telephone | 394-493-0722
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Fax | 877-334-1886
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS14970
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 04125
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License Number State | KY
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