Provider Demographics
NPI:1730426974
Name:SCOTT RUBIN DO
Entity type:Organization
Organization Name:SCOTT RUBIN DO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-365-2828
Mailing Address - Street 1:1700 DR MLK JR ST NO
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33704-1001
Mailing Address - Country:US
Mailing Address - Phone:727-822-1555
Mailing Address - Fax:727-822-1777
Practice Address - Street 1:1700 DR MLK JR ST NO
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33704-1001
Practice Address - Country:US
Practice Address - Phone:727-822-1555
Practice Address - Fax:727-822-1777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-08
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL55304ZOtherNCR#
FL381571400Medicaid