MEDICARE: JAMES H. RUBENSTEIN MD

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	2085R0001X	Radiation Oncology Physician	ME0055380	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	LD513	OTHER		MEDICARE
11	16864	OTHER	FL	WELLCARE-MEDICAID/MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	207227	OTHER	FL	AMERIGROUP GROUP NUMBER
3	24-05261	OTHER	FL	UTD. HLTHCR. PROVIDER #
4	85446	OTHER	FL	OP. ENG. LOC. 825 PROV. #
5	00789	OTHER	FL	UNV. HLTHCR. PROVIDER #
6	0824488-017	OTHER	FL	CIGNA PROVIDER NUMBER
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	3124	OTHER	FL	AVMED PIN NUMBER
9	592485899	OTHER	FL	METCARE VENDOR ID #
10	ME55380A	OTHER	FL	METCARE PROVIDER NUMBER
12	205493	OTHER	FL	AVMED PROVIDER NUMBER
13	4129726	OTHER	FL	AETNA PROVIDER NUMBER
14	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194710384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES H. RUBENSTEIN MD

Provider Business Mailing Address
First Line	:	15681 NEW HAMPSHIRE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4123
Country	:	US
Telephone Number	:	239-437-1977
Fax Number	:	239-437-1889

Provider Business Practice Location Address
First Line	:	15681 NEW HAMPSHIRE CT
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-4123
Country	:	US
Telephone Number	:	239-437-1977
Fax Number	:	239-437-1889

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	12/16/2019

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