MEDICARE: MARCK LUBIN

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	225200000X	Physical Therapy Assistant	PTA2300	FL

General Provider Information

NPI Number	:	1073885596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCK LUBIN

Provider Business Mailing Address
First Line	:	9900 STIRLING RD STE 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8066
Country	:	US
Telephone Number	:	954-432-8872
Fax Number	:

Provider Business Practice Location Address
First Line	:	9900 STIRLING RD STE 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-8066
Country	:	US
Telephone Number	:	954-432-8872
Fax Number	:

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

Provider Enumeration Date	:	01/30/2012
Last Update Date	:	08/09/2023

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