Provider Demographics
NPI:1902108749
Name:PEDIATRIC PULMONARY AND ASTHMA SPECIALISTS
Entity Type:Organization
Organization Name:PEDIATRIC PULMONARY AND ASTHMA SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-931-1812
Mailing Address - Street 1:20776 W DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-1146
Mailing Address - Country:US
Mailing Address - Phone:905-931-1812
Mailing Address - Fax:305-931-1632
Practice Address - Street 1:20776 W DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1146
Practice Address - Country:US
Practice Address - Phone:905-931-1812
Practice Address - Fax:305-931-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00693312080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric PulmonologyGroup - Single Specialty