Healthcare Provider Details

I. General information

NPI: 1245335215
Provider Name (Legal Business Name): JORGE RIBET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1735 E HIGHWAY 50 STE B
CLERMONT FL
34711-5189
US

IV. Provider business mailing address

PO BOX 616788
ORLANDO FL
32861-6788
US

V. Phone/Fax

Practice location:
  • Phone: 352-241-0549
  • Fax: 352-242-9325
Mailing address:
  • Phone: 352-241-0549
  • Fax: 352-242-9325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME93610
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: