Basic Information
| Provider Information | |||||||||
| NPI: | 1417472499 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUBIANO | ||||||||
| FirstName: | CLINTON | ||||||||
| MiddleName: | PIERCE | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RRT, ACCS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14013 SW 79TH ST | ||||||||
| Address2: | |||||||||
| City: | ARCHER | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326184401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2392873012 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1515 SW ARCHER RD | ||||||||
| Address2: | |||||||||
| City: | GAINESVILLE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 326081134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522650111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2017 | ||||||||
| LastUpdateDate: | 08/10/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2279C0205X | RT10722 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Critical Care |
No ID Information.