Provider Demographics
| NPI: | 1407903057 |
|---|---|
| Name: | LEONARD A. RUBINSTEIN M.D P.A. |
| Entity type: | Organization |
| Organization Name: | LEONARD A. RUBINSTEIN M.D P.A. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | LEONARD |
| Authorized Official - Middle Name: | A |
| Authorized Official - Last Name: | RUBINSTEIN |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 941-957-3890 |
| Mailing Address - Street 1: | 1805 SIESTA DR. |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SARASOTA |
| Mailing Address - State: | FL |
| Mailing Address - Zip Code: | 34239 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 941-957-3890 |
| Mailing Address - Fax: | 941-955-1366 |
| Practice Address - Street 1: | 1805 SIESTA DRIVE |
| Practice Address - Street 2: | |
| Practice Address - City: | SARASOTA |
| Practice Address - State: | FL |
| Practice Address - Zip Code: | 34239 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 941-957-3890 |
| Practice Address - Fax: | 941-955-1366 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2007-01-05 |
| Last Update Date: | 2007-11-28 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| FL | ME37720 | 207K00000X, 207KI0005X, 207N00000X, 207YP0228X, 207YS0012X, 207YS0123X, 207YX0007X, 207YX0602X, 207YX0901X, 207YX0905X, 208200000X, 2082S0099X, 2086S0122X, 207Y00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | Group - Multi-Specialty | |
| No | 207K00000X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Group - Multi-Specialty | |
| No | 207KI0005X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Clinical & Laboratory Immunology | Group - Multi-Specialty |
| No | 207N00000X | Allopathic & Osteopathic Physicians | Dermatology | Group - Multi-Specialty | |
| No | 207YP0228X | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology | Group - Multi-Specialty |
| No | 207YS0012X | Allopathic & Osteopathic Physicians | Otolaryngology | Sleep Medicine | Group - Multi-Specialty |
| No | 207YS0123X | Allopathic & Osteopathic Physicians | Otolaryngology | Facial Plastic Surgery | Group - Multi-Specialty |
| No | 207YX0007X | Allopathic & Osteopathic Physicians | Otolaryngology | Plastic Surgery within the Head & Neck | Group - Multi-Specialty |
| No | 207YX0602X | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngic Allergy | Group - Multi-Specialty |
| No | 207YX0901X | Allopathic & Osteopathic Physicians | Otolaryngology | Otology & Neurotology | Group - Multi-Specialty |
| No | 207YX0905X | Allopathic & Osteopathic Physicians | Otolaryngology | Otolaryngology/Facial Plastic Surgery | Group - Multi-Specialty |
| No | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Multi-Specialty | |
| No | 2082S0099X | Allopathic & Osteopathic Physicians | Plastic Surgery | Plastic Surgery Within the Head and Neck | Group - Multi-Specialty |
| No | 2086S0122X | Allopathic & Osteopathic Physicians | Surgery | Plastic and Reconstructive Surgery | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| C31575 | Medicare UPIN | ||
| FL | 58427 | Medicare PIN |