MEDICARE: MYDOLLY MARIA RAMIREZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-25-499031	FL
2	103K00000X	Behavior Analyst	1093449993	FL

General Provider Information

NPI Number	:	1134057961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYDOLLY MARIA RAMIREZ

Provider Business Mailing Address
First Line	:	10921 GABLE ST
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-4017
Country	:	US
Telephone Number	:	305-790-3814
Fax Number	:	305-790-3814

Provider Business Practice Location Address
First Line	:	10921 GABLE ST
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33428-4017
Country	:	US
Telephone Number	:	305-790-3814
Fax Number	:	305-790-3814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/18/2026

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Directions to “ MYDOLLY MARIA RAMIREZ ” Practice Location

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