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General NPI Number Information
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NPI Number | 1700904489
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Entity Type | Individual
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Provider Name | IRVIN MANUEL RUBIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1969 SUNSET PIONT RD #15
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City | CLEARWATER
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State | FL
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Zip | 33765
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Country | US
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Telephone | 727-443-7978
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Fax | 877-989-3173
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Provider Business Mailing Address
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Address Line | 605 CALLE ALMENDRO LOS COLOBOS PARK
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City | CAROLINA
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State | PR
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Zip | 00987-8305
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Country | US
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Telephone | 787-657-4558
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16765
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1325
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License Number State | FL
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