Healthcare Provider Details

I. General information

NPI: 1922761303
Provider Name (Legal Business Name): VIVIANA ANDREA CUESTA RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2021
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10982 NW 48TH LN
DORAL FL
33178-4350
US

IV. Provider business mailing address

10982 NW 48TH LN
DORAL FL
33178-4350
US

V. Phone/Fax

Practice location:
  • Phone: 786-548-9675
  • Fax:
Mailing address:
  • Phone: 786-548-9615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: