MEDICARE: WILLIAM E. RIEBSAME PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TF0200X	Forensic Psychologist	PY0004169	FL
2	103G00000X	Clinical Neuropsychologist	PY0004169	FL
3	103T00000X	Psychologist	PY0004169	FL
4	103TH0100X	Health Service Psychologist	PY0004169	FL

General Provider Information

NPI Number	:	1215937826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM E. RIEBSAME PH.D.

Provider Business Mailing Address
First Line	:	1555 PORT MALABAR BLVD NE
Second Line	:	SUITE 104
City	:	PALM BAY
State	:	FL
Zip	:	32905-5407
Country	:	US
Telephone Number	:	321-729-0870
Fax Number	:	321-952-2516

Provider Business Practice Location Address
First Line	:	1555 PORT MALABAR BLVD NE
Second Line	:	SUITE 104
City	:	PALM BAY
State	:	FL
Zip	:	32905-5407
Country	:	US
Telephone Number	:	321-729-0870
Fax Number	:	321-952-2516

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2005
Last Update Date	:	09/11/2025

Similar Medicare Providers

1336148691 — SHARON F. PELL LCSW
Practice Location Address:

1555 PORT MALABAR BLVD NE , SUITE 104
PALM BAY, FL
32905-5407

Practice Phone: 321-724-0394
Practice Fax: 327-952-2516

1134128325 — DORIS WOLCOTT MS, LMHC
Practice Location Address:

1555 PORT MALABAR BLVD NE , SUITE 104
PALM BAY, FL
32905-5407

Practice Phone: 321-729-0870
Practice Fax: 321-952-2516

1013928514 — CARL D ACQUAVIVA
Practice Location Address:

1555 PORT MALABAR BLVD NE , UNIT 101
PALM BAY, FL
32905-5407

Practice Phone: 321-725-7188
Practice Fax: 321-728-1333

1336262823 — MARIA SIKKING UHLER PHARMD
Practice Location Address:

1555 PORT MALABAR BLVD NE STE 101
PALM BAY, FL
32905-5407

Practice Phone: 321-725-7188
Practice Fax: 321-728-1333

1528203775 — CARL D ACQUAVIVA
Practice Location Address:

1555 PORT MALABAR BLVD NE , SUITE 101
PALM BAY, FL
32905-5407

Practice Phone: 321-725-7188
Practice Fax: 321-728-1333

1780970673 — CARL D ACQUAVIVA
Practice Location Address:

1555 PORT MALABAR BLVD NE STE 102B
PALM BAY, FL
32905-5407

Practice Phone: 321-725-7188
Practice Fax: 321-728-1333

Directions to “ WILLIAM E. RIEBSAME PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.