Provider Demographics
NPI:1558638460
Name:RIBEIRO, ANA MARIA R
Entity Type:Individual
Prefix:MS
First Name:ANA MARIA
Middle Name:R
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ANA MARIA
Other - Middle Name:R
Other - Last Name:RIBEIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:8808 NW 50TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-1940
Mailing Address - Country:US
Mailing Address - Phone:954-255-0739
Mailing Address - Fax:954-772-0175
Practice Address - Street 1:8808 NW 50TH DR
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-1940
Practice Address - Country:US
Practice Address - Phone:954-255-0739
Practice Address - Fax:954-772-0175
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2011-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 30408183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL103043400Medicaid