MEDICARE: JEFFREY E RUBIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DN12852	FL
2	122300000X	Dentist	DN12852	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073520789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY E RUBIN

Provider Business Mailing Address
First Line	:	20843 THISTLE LEAF LN
Second Line	:
City	:	ESTERO
State	:	FL
Zip	:	33928-4082
Country	:	US
Telephone Number	:	239-401-2799
Fax Number	:	239-320-3288

Provider Business Practice Location Address
First Line	:	5995 S POINTE BLVD STE 109
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33919-3273
Country	:	US
Telephone Number	:	239-370-3343
Fax Number	:	239-320-3288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2006
Last Update Date	:	09/25/2025

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Directions to “ JEFFREY E RUBIN ” Practice Location

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