Individual
MRS. MARY-JO RUBIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., P.T., A.P.
Contact information
Practice address
8645 N MILITARY TRL, SUITE 401, WEST PALM BEACH, FL 33410-6294
(561) 776-7170
(561) 776-7171
Mailing address
10803 WHARTON WAY, WEST PALM BEACH, FL 33412-1113
(561) 776-7170
(561) 776-7171
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
95
FL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2048
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
884383000
—
FL
01
—
884383096
MEDICAID WAIVER
FL
01
—
Y7548
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/20/2007
Last updated
09/07/2011
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