MEDICARE: RUBIELA MARIN

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	225700000X	Massage Therapist	MA81025	FL

General Provider Information

NPI Number	:	1700546793
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUBIELA MARIN

Provider Business Mailing Address
First Line	:	435 LAKEVIEW DR APT 101
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-2447
Country	:	US
Telephone Number	:	786-616-2076
Fax Number	:

Provider Business Practice Location Address
First Line	:	435 LAKEVIEW DR APT 101
Second Line	:
City	:	WESTON
State	:	FL
Zip	:	33326-2447
Country	:	US
Telephone Number	:	786-616-2076
Fax Number	:

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

Provider Enumeration Date	:	12/18/2021
Last Update Date	:	12/18/2021

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Directions to “ RUBIELA MARIN ” Practice Location

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