MEDICARE: CLINICA DR RUBIO LLC

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	208D00000X	General Practice Physician		FL
2	208D00000X	General Practice Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972936375
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICA DR RUBIO LLC

Provider Business Mailing Address
First Line	:	2114 MANATEE AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-1660
Country	:	US
Telephone Number	:	941-896-9944
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 MANATEE AVE E
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208
Country	:	US
Telephone Number	:	941-896-9944
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR
Name	:	DR. JAIME F RUBIO
Credential	:
Telephone Number	:	941-735-8315

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	07/21/2022

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Directions to “CLINICA DR RUBIO LLC ” Practice Location

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