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General NPI Number Information
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NPI Number | 1851041370
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Entity Type | Organization
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Legal Business Name | GASTRO FLORIDA PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 03/27/2022
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Last Update Date | 03/27/2022
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Provider Practice Location Address
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Address Line | 21097 NE 27TH CT STE 330
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City | MIAMI
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State | FL
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Zip | 33180-1206
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Country | US
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Telephone | 718-210-2960
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Fax | 941-200-4181
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Provider Business Mailing Address
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Address Line | 111 KENT AVE APT 4M
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City | BROOKLYN
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State | NY
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Zip | 11249-2916
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Country | US
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Telephone | 718-210-2960
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Fax | 941-200-4181
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON RUBINOV
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Credential | MD
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Telephone | 718-210-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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