MEDICARE: DR. RONALD S LUBETSKY M.D.

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	207R00000X	Internal Medicine Physician	ME74933	FL
2	207R00000X	Internal Medicine Physician	ME0074933	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	:	1427002393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD S LUBETSKY M.D.

Provider Business Mailing Address
First Line	:	3131 NE 210TH TER
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33180-3669
Country	:	US
Telephone Number	:	786-274-8080
Fax Number	:	786-274-8949

Provider Business Practice Location Address
First Line	:	1380 NE MIAMI GARDENS DR
Second Line	:	SUITE 280
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33179-4707
Country	:	US
Telephone Number	:	786-274-8080
Fax Number	:	786-274-8949

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/24/2022

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Directions to “ DR. RONALD S LUBETSKY M.D.” Practice Location

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