Provider Demographics
NPI:1033192570
Name:RUBIN, MARK S (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:S
Last Name:RUBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 102222
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-2222
Mailing Address - Country:US
Mailing Address - Phone:239-274-8200
Mailing Address - Fax:239-947-5298
Practice Address - Street 1:9776 BONITA BEACH RD SE
Practice Address - Street 2:#201A
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-4773
Practice Address - Country:US
Practice Address - Phone:239-947-3092
Practice Address - Fax:239-947-1077
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2022-09-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME66879207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL376392700Medicaid
FL830004845OtherRR MEDICARE
FL376392700Medicaid
FL26178SMedicare PIN