Provider Demographics
NPI:1770859795
Name:RIBEIRO, AURELIA LIMA COSTA (MS)
Entity Type:Individual
Prefix:MRS
First Name:AURELIA
Middle Name:LIMA COSTA
Last Name:RIBEIRO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 LISA RD NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-1259
Mailing Address - Country:US
Mailing Address - Phone:321-704-7939
Mailing Address - Fax:
Practice Address - Street 1:1600 SARNO RD
Practice Address - Street 2:216
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-4938
Practice Address - Country:US
Practice Address - Phone:321-431-8811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1119350103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst