Provider Demographics
NPI:1801770193
Name:SOMARIBA, RICARDO J (CCPA)
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:J
Last Name:SOMARIBA
Suffix:
Gender:M
Credentials:CCPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 SW 88TH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1205
Mailing Address - Country:US
Mailing Address - Phone:305-640-5028
Mailing Address - Fax:786-332-4797
Practice Address - Street 1:11010 SW 88TH ST STE 104
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1205
Practice Address - Country:US
Practice Address - Phone:305-640-5028
Practice Address - Fax:786-332-4797
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-01
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCI1365111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology