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General NPI Number Information
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NPI Number | 1629825062
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Entity Type | Individual
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Provider Name | TANIA TAIRY RIBOT MD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2024
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Last Update Date | 07/21/2024
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Provider Practice Location Address
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Address Line | 4 CALLE MORELL CAMPOS
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City | MAYAGUEZ
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State | PR
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Zip | 00680-4846
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Country | US
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Telephone | 787-310-7491
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1095
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City | RINCON
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State | PR
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Zip | 00677-1095
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Country | US
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Telephone | 787-310-7491
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 24022
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License Number State | PR
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