Healthcare Provider Details

I. General information

NPI: 1831146141
Provider Name (Legal Business Name): RALPH S RYBACK MD LP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 HOMESTEAD RD N #102
LEHIGH ACRES FL
33936-6049
US

IV. Provider business mailing address

1415 PANTHER LN #248
NAPLES FL
34109-7874
US

V. Phone/Fax

Practice location:
  • Phone: 239-303-2700
  • Fax: 239-303-2756
Mailing address:
  • Phone: 239-775-4500
  • Fax: 239-775-2990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME92563
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberNPI1508179490
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberME 92563
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: