Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT 18220 | FL |
NPI | 1386753598 |
---|---|
Provider Name | Vicki Ribera |
First Address | Aventura, FL 33180-1731 |
Second Address | Miami, FL 33125-1624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 13/07/2007 |