Provider Demographics
NPI:1114023561
Name:RYBINSKI, JAMES TIMOTHY (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:TIMOTHY
Last Name:RYBINSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 N STONE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3208
Mailing Address - Country:US
Mailing Address - Phone:386-734-2592
Mailing Address - Fax:386-734-1773
Practice Address - Street 1:844 N STONE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3208
Practice Address - Country:US
Practice Address - Phone:386-734-2592
Practice Address - Fax:386-734-1773
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8436111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70048OtherBCBS
FL70048YMedicare ID - Type Unspecified
FLU94393Medicare UPIN