Provider Demographics
NPI:1760584262
Name:RUBIO, ELENA MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:MARIA
Last Name:RUBIO
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 DAYTONIA RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33141-1727
Mailing Address - Country:US
Mailing Address - Phone:305-864-4583
Mailing Address - Fax:
Practice Address - Street 1:1300 DAYTONIA RD
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-1727
Practice Address - Country:US
Practice Address - Phone:305-864-4583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7187235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist