Provider Demographics
NPI:1639818610
Name:RUBINOV, JOHN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:RUBINOV
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 TATUM WATERWAY DR APT 17
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-1986
Mailing Address - Country:US
Mailing Address - Phone:305-319-0240
Mailing Address - Fax:
Practice Address - Street 1:7950 TATUM WATERWAY DR APT 17
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-1986
Practice Address - Country:US
Practice Address - Phone:305-319-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20843101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty