MEDICARE: MARLAN RAMOS MARTINEZ BCBA

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	103K00000X	Behavior Analyst	1-21-57330	TX

General Provider Information

NPI Number	:	1447911763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLAN RAMOS MARTINEZ BCBA

Provider Business Mailing Address
First Line	:	8851 SW 208TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-3882
Country	:	US
Telephone Number	:	786-599-2894
Fax Number	:

Provider Business Practice Location Address
First Line	:	8851 SW 208TH TER
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-3882
Country	:	US
Telephone Number	:	786-599-2894
Fax Number	:

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

Provider Enumeration Date	:	01/08/2022
Last Update Date	:	07/15/2025

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