Individual provider Active NPI

Mario Rub, M.D.

  • Pediatric Pulmonology Physician
  • Miami, FL
National Provider Identifier
1790889996
Registry record updated Dec 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
ME0069331 Issued in FL
Practice address
20776 W Dixie Hwy
Miami, FL 33180
Phone
(305) 931-1812
Fax
(305) 931-1632
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pulmonology Physician 2080P0214X ME0069331 FL Primary

Addresses

Primary practice location

20776 W Dixie Hwy
Miami, FL 33180

Mailing address

20776 W Dixie Hwy
Miami, FL 33180
Phone (305) 931-1812

Other identifiers 1

IdentifierTypeStateIssuer
256291000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME0069331FLMDPediatric Pulmonology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Pulmonary and Asthma Specialists Pediatric Pulmonology Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293580800000",
    "number": "1790889996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20776 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-931-1812",
            "fax_number": "305-931-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20776 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "33180",
            "telephone_number": "305-931-1812",
            "fax_number": "305-931-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUB",
        "first_name": "MARIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2010-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "FL",
            "license": "ME0069331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256291000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.