Provider Demographics
NPI:1073358859
Name:RUBIO, GABRIEL HARAK
Entity type:Individual
Prefix:
First Name:GABRIEL
Middle Name:HARAK
Last Name:RUBIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3636 HOOFPRINT DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-2357
Mailing Address - Country:US
Mailing Address - Phone:718-877-3159
Mailing Address - Fax:
Practice Address - Street 1:3636 HOOFPRINT DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-2357
Practice Address - Country:US
Practice Address - Phone:718-877-3159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health