Provider Demographics
NPI:1962572578
Name:RUBIO, ELENA H (RPH)
Entity type:Individual
Prefix:MRS
First Name:ELENA
Middle Name:H
Last Name:RUBIO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4943 SW 158TH WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5606
Mailing Address - Country:US
Mailing Address - Phone:954-435-8834
Mailing Address - Fax:
Practice Address - Street 1:1630 W 49TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2931
Practice Address - Country:US
Practice Address - Phone:305-822-6025
Practice Address - Fax:305-822-6028
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS35481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist