Provider Demographics
NPI:1255532933
Name:RUBIO GONZALEZ, JAIME ELI (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ELI
Last Name:RUBIO GONZALEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 SE 18TH PL STE 2
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5404
Mailing Address - Country:US
Mailing Address - Phone:352-861-5765
Mailing Address - Fax:352-867-1801
Practice Address - Street 1:1133 SE 18TH PL STE 2
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5404
Practice Address - Country:US
Practice Address - Phone:352-861-5765
Practice Address - Fax:352-732-8036
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLACN194208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL280272400Medicaid
FL280272400Medicaid
FLAJ517ZMedicare PIN