Provider Demographics
NPI:1265414353
Name:RIBAY, MA TERESITA DELA ROSA (MD)
Entity type:Individual
Prefix:
First Name:MA TERESITA
Middle Name:DELA ROSA
Last Name:RIBAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MA. TERESITA
Other - Middle Name:CARANGAL
Other - Last Name:DELA ROSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3953
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34478-3953
Mailing Address - Country:US
Mailing Address - Phone:352-732-6599
Mailing Address - Fax:352-732-4816
Practice Address - Street 1:1025 SW 1ST AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0900
Practice Address - Country:US
Practice Address - Phone:352-732-6599
Practice Address - Fax:352-732-4816
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52090208000000X
FLME70012208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2504448-00Medicaid
FL250444800Medicaid
G42782Medicare UPIN
FL2504448-00Medicaid
FL32494Medicare PIN