Provider Demographics
NPI:1871551408
Name:LUBIN, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:LUBIN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15320 AMBERLY DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1647
Mailing Address - Country:US
Mailing Address - Phone:831-977-0733
Mailing Address - Fax:813-971-2230
Practice Address - Street 1:508 S HABANA AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4181
Practice Address - Country:US
Practice Address - Phone:831-872-3164
Practice Address - Fax:813-874-2225
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME0028124207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D53806Medicare UPIN
29957UMedicare ID - Type Unspecified