Provider Demographics
NPI:1154538841
Name:MARK RUBENSTEIN, MD, PA
Entity type:Organization
Organization Name:MARK RUBENSTEIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-832-5000
Mailing Address - Street 1:PO BOX 8354
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33468-8354
Mailing Address - Country:US
Mailing Address - Phone:561-832-5000
Mailing Address - Fax:561-832-3005
Practice Address - Street 1:1411 N FLAGLER DR
Practice Address - Street 2:STE 6400
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-3404
Practice Address - Country:US
Practice Address - Phone:561-832-5000
Practice Address - Fax:561-832-3005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME006770174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26731OtherBCBS
FL26731OtherBCBS
FL26731AMedicare ID - Type Unspecified