Provider Demographics
NPI:1740929082
Name:RAUB, ASHLEY SUSAN (OD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUSAN
Last Name:RAUB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ROSSBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:500 NORTH OLD DIXIE HIGHWAY
Mailing Address - Street 2:UNIT 2
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-4969
Mailing Address - Country:US
Mailing Address - Phone:305-484-4111
Mailing Address - Fax:561-354-0152
Practice Address - Street 1:903 WEST INDIANTOWN ROAD
Practice Address - Street 2:SUITE 105
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-6850
Practice Address - Country:US
Practice Address - Phone:561-295-8654
Practice Address - Fax:561-828-8367
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC6067152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist