Organization
PICASSO AESTHETIC AND COSMETIC DENTAL SPA PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RUBIN (PRESIDENT)
(239) 370-3343
Entity
Organization
Contact information
Practice address
3660 CENTRAL AVE STE 14, FORT MYERS, FL 33901-8258
(239) 401-2799
(239) 320-3288
Mailing address
20843 THISTLE LEAF LN, ESTERO, FL 33928-4082
(239) 401-2799
(239) 320-3288
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DN12852
FL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070759700
—
FL
Enumeration date
07/27/2012
Last updated
03/05/2026
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