Provider Demographics
NPI:1285644013
Name:RUBIN, LAWRENCE BENJAMIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:BENJAMIN
Last Name:RUBIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17158 NE 19TH AVE
Mailing Address - Street 2:DR LAWRENCE B RUBIN
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162
Mailing Address - Country:US
Mailing Address - Phone:305-940-3114
Mailing Address - Fax:
Practice Address - Street 1:17158 NE 19TH AVE
Practice Address - Street 2:DR LAWRENCE B RUBIN
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-3102
Practice Address - Country:US
Practice Address - Phone:305-940-3114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO421213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T55355Medicare UPIN
FL87167Medicare ID - Type Unspecified