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General NPI Number Information
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NPI Number | 1780019885
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Entity Type | Individual
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Provider Name | MOHAMMED K ALRUBAIE BDS
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Gender | Male
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Dates
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Enumeration Date | 09/08/2013
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Last Update Date | 11/06/2015
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Provider Practice Location Address
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Address Line | 19001 N TAMIAMI TRL STE 4
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City | FORT MYERS
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State | FL
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Zip | 33903-7306
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Country | US
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Telephone | 773-344-5737
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Fax |
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Provider Business Mailing Address
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Address Line | 11503 SW 26TH PL APT 303
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City | MIRAMAR
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State | FL
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Zip | 33025-7545
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Country | US
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Telephone | 773-344-5737
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN21613
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License Number State | FL
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