Provider Demographics
NPI:1669572020
Name:LUBETKIN, DAVID IAN (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:IAN
Last Name:LUBETKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 NW 13TH ST STE 101A
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-2269
Mailing Address - Country:US
Mailing Address - Phone:561-300-0600
Mailing Address - Fax:561-300-0601
Practice Address - Street 1:1001 NW 13TH ST STE 101A
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2269
Practice Address - Country:US
Practice Address - Phone:561-300-0600
Practice Address - Fax:561-300-0601
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069953207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
28503Medicare ID - Type Unspecified
G24728Medicare UPIN