Provider Demographics
NPI:1841837333
Name:RUBIO, DEBBIE J (RD)
Entity type:Individual
Prefix:MS
First Name:DEBBIE
Middle Name:J
Last Name:RUBIO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 S HAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8111
Mailing Address - Country:US
Mailing Address - Phone:561-596-0371
Mailing Address - Fax:866-304-7599
Practice Address - Street 1:725 SE PORT ST LUCIE BLVD STE 204
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34984-5232
Practice Address - Country:US
Practice Address - Phone:561-596-0371
Practice Address - Fax:866-304-7599
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL86148591133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered