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General NPI Number Information
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NPI Number | 1457337826
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Entity Type | Individual
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Provider Name | MITCHELL JAY RUBIN MD
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Gender | Male
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 09/02/2016
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Provider Practice Location Address
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Address Line | 3848 FAU BOULEVARD SUITE 305
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City | BOCA RATON
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State | FL
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Zip | 33431-5811
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Country | US
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Telephone | 305-243-3100
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Fax | 561-393-7312
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Provider Business Mailing Address
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Address Line | 3848 FAU BOULEVARD SUITE 305
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City | BOCA RATON
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State | FL
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Zip | 33431-5811
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Country | US
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Telephone | 305-243-3100
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Fax | 561-393-7312
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA045678
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA04567800
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME97699
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License Number State | FL
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