Provider Demographics
NPI:1447694187
Name:RUBIO, GLADIS (CLC)
Entity type:Individual
Prefix:MS
First Name:GLADIS
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2941 SHORE DR
Mailing Address - Street 2:UNIT C
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-4755
Mailing Address - Country:US
Mailing Address - Phone:727-657-7370
Mailing Address - Fax:
Practice Address - Street 1:2941 SHORE DR
Practice Address - Street 2:UNIT C
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-4755
Practice Address - Country:US
Practice Address - Phone:727-657-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALPP-37965174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN