Provider Demographics
NPI:1114904802
Name:RUBIANES, ELBA I (MD)
Entity Type:Individual
Prefix:DR
First Name:ELBA
Middle Name:I
Last Name:RUBIANES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELBA
Other - Middle Name:IRIS
Other - Last Name:RUBIANES-COLLAZO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4471 LONG PRAIRIE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1755
Mailing Address - Country:US
Mailing Address - Phone:972-316-4555
Mailing Address - Fax:972-316-4550
Practice Address - Street 1:6000 W SPRING CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3617
Practice Address - Country:US
Practice Address - Phone:972-316-4555
Practice Address - Fax:214-285-0791
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0065725207N00000X, 207NS0135X
TXR9851207NS0135X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL926255OtherNAPLES PHO NUMBER
FL25372OtherBCBS OF FL
FLF83866Medicare UPIN
FL25372OtherBCBS OF FL