Provider Demographics
NPI:1497131338
Name:DR. LAURA M KUBAT, INC.
Entity Type:Organization
Organization Name:DR. LAURA M KUBAT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KUBAT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:954-336-3512
Mailing Address - Street 1:1401 SW 66TH TER
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-5131
Mailing Address - Country:US
Mailing Address - Phone:954-336-3512
Mailing Address - Fax:
Practice Address - Street 1:1401 SW 66TH TER
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-5131
Practice Address - Country:US
Practice Address - Phone:954-336-3512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7747251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health