MEDICARE: MRS. AMBER LISET 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	156FX1800X	Optician	LDO003143	GA

General Provider Information

NPI Number	:	1972435170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMBER LISET RAMOS

Provider Business Mailing Address
First Line	:	5590 MABLETON PKWY SW STE 138-109
Second Line	:
City	:	MABLETON
State	:	GA
Zip	:	30126-3344
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1785 COBB PKWY S
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-9288
Country	:	US
Telephone Number	:	770-955-5019
Fax Number	:	770-955-7349

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

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MRS. AMBER LISET RAMOS ” Practice Location

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