MEDICARE: KATIE ANN RAMOS

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

General Provider Information

NPI Number	:	1790514933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE ANN RAMOS

Provider Business Mailing Address
First Line	:	4917 LAKE RIDGE LN
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-5526
Country	:	US
Telephone Number	:	727-564-2857
Fax Number	:

Provider Business Practice Location Address
First Line	:	4917 LAKE RIDGE LN
Second Line	:
City	:	HOLIDAY
State	:	FL
Zip	:	34690-5526
Country	:	US
Telephone Number	:	727-564-2857
Fax Number	:

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

Provider Enumeration Date	:	07/27/2024
Last Update Date	:	07/27/2024

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Directions to “ KATIE ANN RAMOS ” Practice Location

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