Provider Demographics
NPI:1922810787
Name:CHIRIBOGA, MARIA LORENA (CHI SPANISH)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LORENA
Last Name:CHIRIBOGA
Suffix:
Gender:F
Credentials:CHI SPANISH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MALLET HILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29223-3216
Mailing Address - Country:US
Mailing Address - Phone:803-600-2103
Mailing Address - Fax:
Practice Address - Street 1:3540 NW 30TH BLVD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-2609
Practice Address - Country:US
Practice Address - Phone:803-600-2103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
025055171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter