MEDICARE: SYLVESTER STEVEN RIBAUDO DPT

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	225100000X	Physical Therapist	LPT-013128	AZ

General Provider Information

NPI Number	:	1669227369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVESTER STEVEN RIBAUDO DPT

Provider Business Mailing Address
First Line	:	6933 N GALAXY PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2712
Country	:	US
Telephone Number	:	316-218-5291
Fax Number	:

Provider Business Practice Location Address
First Line	:	6933 N GALAXY PL
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85741-2712
Country	:	US
Telephone Number	:	316-218-5291
Fax Number	:

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

Provider Enumeration Date	:	04/17/2024
Last Update Date	:	04/17/2024

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