Provider Demographics
NPI:1306802186
Name:RUB, BENY (MD)
Entity type:Individual
Prefix:
First Name:BENY
Middle Name:
Last Name:RUB
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 1:21110 BISCAYNE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:AVENTURA
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1228
Mailing Address - Country:US
Mailing Address - Phone:305-932-1007
Mailing Address - Fax:305-696-6225
Practice Address - Street 1:21110 BISCAYNE BLVD STE 106
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-1228
Practice Address - Country:US
Practice Address - Phone:305-932-1007
Practice Address - Fax:305-696-6225
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME55002208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1682002007OtherCIGNA
FL051961801Medicaid
FL1272036OtherUNITED MEDICAID
FLGHIOther2699837
FL1202260OtherUNITED
FL4127018OtherAETNA
FL0000684OtherCIGNA 2
FL002547OtherNHP
FL102898OtherAVMED
FL10398OtherBCBS HEALTH OPTIONS
FL000100573OtherHUMANA