Individual
JON K. GUBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1600 S ANDREWS AVE, FT LAUDERDALE, FL 33316-2510
(954) 355-5500
Mailing address
1801S PERIMETER RD 180, FORT LAUDERDALE, FL 33309-7140
(954) 839-8080
(954) 839-8081
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
ME53318
FL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
ME53318
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037684100
—
FL
01
—
30033745
RAILROAD MEDICARE
FL
Enumeration date
12/06/2005
Last updated
03/13/2020
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