Provider Demographics
NPI:1760528822
Name:RIBBLER, ALLAN E (PHD)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:E
Last Name:RIBBLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 NW 74TH AVE
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-1618
Mailing Address - Country:US
Mailing Address - Phone:954-321-1980
Mailing Address - Fax:954-321-0747
Practice Address - Street 1:410 NW 74TH AVE
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-1618
Practice Address - Country:US
Practice Address - Phone:954-321-1980
Practice Address - Fax:954-321-0747
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY4518103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59440OtherBCBS OF FL PROVIDER ID#
FL59440OtherBCBS OF FL PROVIDER ID#
FL59440XMedicare ID - Type Unspecified