MEDICARE: PATRICK E RUBSAMEN 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	207W00000X	Ophthalmology Physician	ME50471	FL
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME50471	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10128	OTHER	FL	BCBSFL
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215935382
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK E RUBSAMEN MD

Provider Business Mailing Address
First Line	:	6333 N FEDERAL HWY
Second Line	:	SUITE 300
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-1907
Country	:	US
Telephone Number	:	954-776-6880
Fax Number	:	954-229-3100

Provider Business Practice Location Address
First Line	:	6333 N FEDERAL HWY
Second Line	:	SUITE 300
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33308-1907
Country	:	US
Telephone Number	:	954-776-6880
Fax Number	:	954-229-3100

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/14/2021

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Directions to “ PATRICK E RUBSAMEN MD” Practice Location

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