Provider Demographics
NPI:1982834032
Name:BUBUCEA, MARIANA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIANA
Middle Name:
Last Name:BUBUCEA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 901
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4726
Mailing Address - Country:US
Mailing Address - Phone:954-204-0054
Mailing Address - Fax:954-505-4491
Practice Address - Street 1:1920 E HALLANDALE BEACH BLVD STE 901
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4726
Practice Address - Country:US
Practice Address - Phone:954-204-0054
Practice Address - Fax:954-505-4491
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113594207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006257100Medicaid
FL006257100Medicaid