Healthcare Provider Details

I. General information

NPI: 1205343571
Provider Name (Legal Business Name): EDAILYN RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

756 W PALM DR
FLORIDA CITY FL
33034-3224
US

IV. Provider business mailing address

756 W PALM DR
FLORIDA CITY FL
33034-3224
US

V. Phone/Fax

Practice location:
  • Phone: 305-246-2530
  • Fax: 305-246-4585
Mailing address:
  • Phone: 305-246-3530
  • Fax: 305-246-4585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: