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General NPI Number Information
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NPI Number | 1508382649
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN RIBEIRO DPT
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Gender | Female
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Dates
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Enumeration Date | 08/21/2017
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 2449 3RD ST S STE 2449
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-4066
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Country | US
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Telephone | 904-372-4016
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Fax |
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Provider Business Mailing Address
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Address Line | 70 MARTHA CT
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City | ST AUGUSTINE
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State | FL
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Zip | 32092-3339
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Country | US
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Telephone | 727-410-0721
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070.023215
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT36319
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License Number State | FL
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