Provider Demographics
NPI:1477558096
Name:RUBENSTEIN, RICHARD MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MICHAEL
Last Name:RUBENSTEIN
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 1:7421 N UNIVERSITY DR
Mailing Address - Street 2:STE 307
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6102
Mailing Address - Country:US
Mailing Address - Phone:954-720-7272
Mailing Address - Fax:954-720-1878
Practice Address - Street 1:7421 N UNIVERSITY DR
Practice Address - Street 2:STE 307
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-6102
Practice Address - Country:US
Practice Address - Phone:954-720-7272
Practice Address - Fax:954-720-1878
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53550207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL05980YMedicare ID - Type Unspecified
FLD19040Medicare UPIN