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NPI Code Detail

MEDICARE: JILL RUBOLINO APRN

MEDICARE: JILL RUBOLINO APRN
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
1363LF0000XFamily Nurse Practitioner1073616TX
2363LF0000XFamily Nurse PractitionerAPRN11024103FL

General Provider Information

NPI Number : 1851012421
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL RUBOLINO APRN
Provider Business Mailing Address
First Line : 222 N PACIFIC COAST HWY STE 2175
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5639
Country : US
Telephone Number : 877-878-3289
Fax Number :
Provider Business Practice Location Address
First Line : 3434 WATTERS RD
Second Line :
City : PASADENA
State : TX
Zip : 77504-2015
Country : US
Telephone Number : 713-941-9155
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2022
Last Update Date : 01/15/2026

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