# PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205182276
- **Authorized official:** JEFFREY RUBIN (PRESIDENT)
- **Authorized official phone:** (239) 370-3343

## Contact information

- **Practice address:** 3660 CENTRAL AVE STE 14, FORT MYERS, FL 33901-8258
- **Practice address phone:** (239) 401-2799
- **Practice address fax:** (239) 320-3288
- **Mailing address:** 20843 THISTLE LEAF LN, ESTERO, FL 33928-4082
- **Mailing address phone:** (239) 401-2799
- **Mailing address fax:** (239) 320-3288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DN12852 | FL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 07/27/2012
- **Last updated:** 03/05/2026