Provider Demographics
NPI:1992089023
Name:RUBIO, MONIQUE MARIE (LMT)
Entity type:Individual
Prefix:MS
First Name:MONIQUE
Middle Name:MARIE
Last Name:RUBIO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6433
Mailing Address - Country:US
Mailing Address - Phone:813-354-8744
Mailing Address - Fax:813-354-8841
Practice Address - Street 1:4123 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6433
Practice Address - Country:US
Practice Address - Phone:813-354-8744
Practice Address - Fax:813-354-8841
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-07
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA50289225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist