Provider Demographics
NPI:1689488538
Name:RUBIES, GONZALO FERNANDO (SA)
Entity type:Individual
Prefix:
First Name:GONZALO
Middle Name:FERNANDO
Last Name:RUBIES
Suffix:
Gender:M
Credentials:SA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8375 NW 53RD ST
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-4611
Mailing Address - Country:US
Mailing Address - Phone:786-767-9080
Mailing Address - Fax:
Practice Address - Street 1:8375 NW 53RD ST
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-4611
Practice Address - Country:US
Practice Address - Phone:786-767-9080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant