Provider Demographics
NPI:1508824269
Name:RUBINO, MICHAEL EMMANUEL (DPT, MTC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:EMMANUEL
Last Name:RUBINO
Suffix:
Gender:M
Credentials:DPT, MTC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 RAINBOW CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1512
Mailing Address - Country:US
Mailing Address - Phone:786-269-3454
Mailing Address - Fax:
Practice Address - Street 1:25241 ELEMENTARY WAY
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7883
Practice Address - Country:US
Practice Address - Phone:786-269-3454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 22469225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU6967ZMedicare ID - Type UnspecifiedINDIVIDUAL PRACTIONER