MEDICARE: DR. ANITE LUBIN 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	207R00000X	Internal Medicine Physician	ME71876	FL

General Provider Information

NPI Number	:	1700861770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITE LUBIN MD

Provider Business Mailing Address
First Line	:	4724 MONROE ST
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-7264
Country	:	US
Telephone Number	:	786-280-6474
Fax Number	:	305-981-2600

Provider Business Practice Location Address
First Line	:	18250 NW 2ND AVE
Second Line	:	SUITE 202
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33169-5011
Country	:	US
Telephone Number	:	305-249-0070
Fax Number	:	305-828-3419

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

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	07/09/2007

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