Provider Demographics
NPI:1417750860
Name:RUBI, KELLY DYAN (PHARMD, CPH, BCPS,)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:DYAN
Last Name:RUBI
Suffix:
Gender:
Credentials:PHARMD, CPH, BCPS,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8950 N KENDALL DR STE 507
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-2127
Mailing Address - Country:US
Mailing Address - Phone:867-662-0882
Mailing Address - Fax:786-591-6085
Practice Address - Street 1:8950 N KENDALL DR STE 507
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2127
Practice Address - Country:US
Practice Address - Phone:786-662-0882
Practice Address - Fax:786-591-6085
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPU10067183500000X
FLPS645281835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist