Provider Demographics
NPI:1720202377
Name:LUBIN, MICHAEL ZEV
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:ZEV
Last Name:LUBIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 PALM LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2037
Mailing Address - Country:US
Mailing Address - Phone:813-657-1810
Mailing Address - Fax:813-627-7089
Practice Address - Street 1:1630 PALM LEAF DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2037
Practice Address - Country:US
Practice Address - Phone:813-657-1810
Practice Address - Fax:813-627-7089
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL465282471N0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471N0900XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistNuclear Medicine Technology