Provider Demographics
NPI:1992757033
Name:SKUBAN, RENEE PAULETTE (AP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:PAULETTE
Last Name:SKUBAN
Suffix:
Gender:F
Credentials:AP
Other - Prefix:MS
Other - First Name:PAULETTE
Other - Middle Name:MARIE
Other - Last Name:KARR-SKUBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AP
Mailing Address - Street 1:10600 SW 77TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2907
Mailing Address - Country:US
Mailing Address - Phone:305-495-6026
Mailing Address - Fax:305-495-6026
Practice Address - Street 1:7800 RED RD
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-495-6026
Practice Address - Fax:305-495-6026
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1415171100000X
FLMA 43419225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist