Provider Demographics
NPI:1457340366
Name:RIPPL, DIANA MARTA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARTA
Last Name:RIPPL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2328 HANCOCK BRIDGE PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-1459
Mailing Address - Country:US
Mailing Address - Phone:239-574-8922
Mailing Address - Fax:239-573-7356
Practice Address - Street 1:1900 TRAILWINDS DR
Practice Address - Street 2:# 4
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3051
Practice Address - Country:US
Practice Address - Phone:239-481-5552
Practice Address - Fax:239-275-8072
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT-22212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist