Provider Demographics
NPI:1013313121
Name:RUBINO, CAROLINE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:RUBINO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 MOSS CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80526-3167
Mailing Address - Country:US
Mailing Address - Phone:303-378-4563
Mailing Address - Fax:
Practice Address - Street 1:2118 LONGFIN CT
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CO
Practice Address - Zip Code:80550-3344
Practice Address - Country:US
Practice Address - Phone:970-690-7337
Practice Address - Fax:970-460-0507
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0004090225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO20673345Medicaid