Healthcare Provider Details

I. General information

NPI: 1528318771
Provider Name (Legal Business Name): RIOBE INSTITUTE OF HOLISTIC GYNECOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 09/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SE OCEAN BLVD SUITE 200-B
STUART FL
34996-3332
US

IV. Provider business mailing address

2100 SE OCEAN BLVD SUITE 200-B
STUART FL
34996-3332
US

V. Phone/Fax

Practice location:
  • Phone: 772-266-4258
  • Fax: 772-219-8111
Mailing address:
  • Phone: 772-266-4258
  • Fax: 772-219-8111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberME82630
License Number StateFL

VIII. Authorized Official

Name: DR. MYLAINE RIOBE
Title or Position: DIRECTOR
Credential: MD
Phone: 772-266-4258