Healthcare Provider Details

I. General information

NPI: 1144599374
Provider Name (Legal Business Name): ROSA B RIBON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2011
Last Update Date: 11/23/2022
Certification Date: 11/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3848 FAU BLVD SUITE # 305
BOCA RATON FL
33431-6437
US

IV. Provider business mailing address

3848 FAU BLVD SUITE # 305
BOCA RATON FL
33431-6437
US

V. Phone/Fax

Practice location:
  • Phone: 561-455-3627
  • Fax:
Mailing address:
  • Phone: 561-455-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME113581
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME113581
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: