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General NPI Number Information
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NPI Number | 1861682940
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Entity Type | Individual
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Provider Name | RUBINA Y BAKERYWALA M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 2601 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2112
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Country | US
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Telephone | 904-203-4282
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Fax | 564-464-3967
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Provider Business Mailing Address
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Address Line | 2601 UNIVERSITY BLVD W
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City | JACKSONVILLE
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State | FL
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Zip | 32217-2112
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Country | US
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Telephone | 904-203-4282
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Fax | 564-464-3967
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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 | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | 245248
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084N0402X
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Taxonomy Name | Neurology with Special Qualifications in Child Neurology Physician
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License Number | ME109578
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License Number State | FL
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