Provider Demographics
NPI:1588951982
Name:RALPH RYBACK MD LP
Entity type:Organization
Organization Name:RALPH RYBACK MD LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RALPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:RYBACK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-597-5075
Mailing Address - Street 1:2614 TAMIAMI TRAIL NORTH
Mailing Address - Street 2:SUITE 330
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103
Mailing Address - Country:US
Mailing Address - Phone:352-597-5075
Mailing Address - Fax:352-597-9900
Practice Address - Street 1:2614 TAMIAMI TRL N
Practice Address - Street 2:SUITE 330
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4409
Practice Address - Country:US
Practice Address - Phone:352-597-5075
Practice Address - Fax:352-597-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-06
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92563103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty