MEDICARE: HECTOR RUBIO

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	225200000X	Physical Therapy Assistant	PTA 26288	FL

General Provider Information

NPI Number	:	1902270572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HECTOR RUBIO

Provider Business Mailing Address
First Line	:	1432 NE 13TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1337
Country	:	US
Telephone Number	:	954-801-3768
Fax Number	:

Provider Business Practice Location Address
First Line	:	1432 NE 13TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33304-1337
Country	:	US
Telephone Number	:	954-801-3768
Fax Number	:

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

Provider Enumeration Date	:	11/19/2015
Last Update Date	:	11/19/2015

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Directions to “ HECTOR RUBIO ” Practice Location

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