Provider Demographics
NPI:1225910854
Name:RIBOTT DIAZ, ROXANE (DSW)
Entity type:Individual
Prefix:DR
First Name:ROXANE
Middle Name:
Last Name:RIBOTT DIAZ
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L-48 CALLE 17
Mailing Address - Street 2:RIO GRANDE ESTATES
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-5015
Mailing Address - Country:US
Mailing Address - Phone:787-382-0920
Mailing Address - Fax:
Practice Address - Street 1:ATRIUM BUSSINESS
Practice Address - Street 2:530 AVE. CONSTITUCION SUITE 226
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00901-2304
Practice Address - Country:US
Practice Address - Phone:787-382-0920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR46691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical