Provider Demographics
NPI:1548514664
Name:TUBINO, RICARDO D (PT)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:D
Last Name:TUBINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17070 COLLINS AVE STE 254
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-3635
Mailing Address - Country:US
Mailing Address - Phone:305-947-7788
Mailing Address - Fax:305-947-5458
Practice Address - Street 1:17070 COLLINS AVE STE 254
Practice Address - Street 2:
Practice Address - City:SUNNY ISLES BEACH
Practice Address - State:FL
Practice Address - Zip Code:33160-3635
Practice Address - Country:US
Practice Address - Phone:305-947-7788
Practice Address - Fax:305-947-5458
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist