Healthcare Provider Details

I. General information

NPI: 1639789670
Provider Name (Legal Business Name): REIBY BALBI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E BLOOMINGDALE AVE
BRANDON FL
33511-8155
US

IV. Provider business mailing address

1383 ANCHOR BEND DR
RUSKIN FL
33570-8086
US

V. Phone/Fax

Practice location:
  • Phone: 813-655-8159
  • Fax:
Mailing address:
  • Phone: 347-321-5280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: