Provider Demographics
NPI:1427002393
Name:LUBETSKY, RONALD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:S
Last Name:LUBETSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 NE 210TH TER
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-3669
Mailing Address - Country:US
Mailing Address - Phone:786-274-8080
Mailing Address - Fax:786-274-8949
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:SUITE 280
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4707
Practice Address - Country:US
Practice Address - Phone:786-274-8080
Practice Address - Fax:786-274-8949
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME74933207R00000X
FLME0074933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257907300Medicaid
FLG80250Medicare UPIN
FLE1237Medicare PIN