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General NPI Number Information
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NPI Number | 1144299124
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Entity Type | Individual
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Provider Name | ANGEL I RIBO PA
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 240 N FREDERICK AVE
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-3400
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Country | US
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Telephone | 386-255-5569
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Fax | 386-256-4730
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Provider Business Mailing Address
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Address Line | 90 N LAKEWALK DR
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City | PALM COAST
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State | FL
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Zip | 32137-1304
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Country | US
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Telephone | 903-445-9363
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Fax | 833-490-1306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | PA9105286
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | PA9105286
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | PA9105286
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA02326
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9105286
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | PA9105286
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License Number State | FL
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