Provider Demographics
NPI:1043490584
Name:ALLAN RUBIN DO PA
Entity Type:Organization
Organization Name:ALLAN RUBIN DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-963-3330
Mailing Address - Street 1:3816 HOLLYWOOD BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021
Mailing Address - Country:US
Mailing Address - Phone:954-963-3330
Mailing Address - Fax:954-963-3364
Practice Address - Street 1:3816 HOLLYWOOD BLVD
Practice Address - Street 2:STE 101
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021
Practice Address - Country:US
Practice Address - Phone:954-963-3330
Practice Address - Fax:954-963-3364
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALLAN RUBIN DO PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS1876207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE12039Medicare UPIN
FL81889Medicare PIN