Provider Demographics
NPI:1780019885
Name:ALRUBAIE, MOHAMMED K (BDS)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:K
Last Name:ALRUBAIE
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11503 SW 26TH PL APT 303
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7545
Mailing Address - Country:US
Mailing Address - Phone:773-344-5737
Mailing Address - Fax:
Practice Address - Street 1:19001 N TAMIAMI TRL STE 4
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33903-7306
Practice Address - Country:US
Practice Address - Phone:773-344-5737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-08
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist