MEDICARE: MRS. NINA B LUBISCH ARNP

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	363LF0000X	Family Nurse Practitioner	1556452	FL

General Provider Information

NPI Number	:	1881691889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NINA B LUBISCH ARNP

Provider Business Mailing Address
First Line	:	1600 S ANDREWS AVE
Second Line	:	DEPARTMENT OF PEDIATRIC ADMINISTRATION
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2510
Country	:	US
Telephone Number	:	954-712-3984
Fax Number	:	954-468-4012

Provider Business Practice Location Address
First Line	:	1600 S ANDREWS AVE
Second Line	:	DEPARTMENT OF PEDIATRIC ADMINISTRATION
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33316-2510
Country	:	US
Telephone Number	:	954-712-3984
Fax Number	:	954-468-4012

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	07/08/2007

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