Provider Demographics
NPI:1194710384
Name:RUBENSTEIN, JAMES H (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:RUBENSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15681 NEW HAMPSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-4123
Mailing Address - Country:US
Mailing Address - Phone:239-437-1977
Mailing Address - Fax:239-437-1889
Practice Address - Street 1:15681 NEW HAMPSHIRE CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4123
Practice Address - Country:US
Practice Address - Phone:239-437-1977
Practice Address - Fax:239-437-1889
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00553802085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL207227OtherAMERIGROUP GROUP NUMBER
LD513OtherMEDICARE
FL24-05261OtherUTD. HLTHCR. PROVIDER #
FL85446OtherOP. ENG. LOC. 825 PROV. #
FL00789OtherUNV. HLTHCR. PROVIDER #
FL0824488-017OtherCIGNA PROVIDER NUMBER
FL061469600Medicaid
FL3124OtherAVMED PIN NUMBER
FL592485899OtherMETCARE VENDOR ID #
FLME55380AOtherMETCARE PROVIDER NUMBER
FL16864OtherWELLCARE-MEDICAID/MEDICARE
FL205493OtherAVMED PROVIDER NUMBER
FL4129726OtherAETNA PROVIDER NUMBER
FL85446OtherOP. ENG. LOC. 825 PROV. #