Basic Information
| Provider Information | |||||||||
| NPI: | 1174533988 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUBIN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | IRA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1001 NW 13TH ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334862269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619556663 | ||||||||
| FaxNumber: | 5619552879 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 NW 13TH ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | BOCA RATON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334862269 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619555740 | ||||||||
| FaxNumber: | 5619556107 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2006 | ||||||||
| LastUpdateDate: | 05/27/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD429131 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | ME152650 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.