Provider Demographics
NPI:1982453262
Name:RUBIO ZEPEDA, ANDRES LEONARDO (APRN)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:LEONARDO
Last Name:RUBIO ZEPEDA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 NW 16TH ST # 103
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33313-5100
Mailing Address - Country:US
Mailing Address - Phone:954-470-8832
Mailing Address - Fax:
Practice Address - Street 1:7401 NW 16TH ST # 103
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-5100
Practice Address - Country:US
Practice Address - Phone:954-470-8832
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF04240024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily