Individual
RICARDO P MARIBONA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
4428 MAIN ST, SHALLOTTE, NC 28470-4450
(910) 755-3338
(910) 754-3335
Mailing address
4428 MAIN ST, SHALLOTTE, NC 28470-4450
(910) 755-3338
(910) 754-3335
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
P02055
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093830001
MEDICARE DME
FL
01
—
4800018180
RAILROAD MEDICARE
FL
Enumeration date
12/19/2005
Last updated
09/02/2021
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