Healthcare Provider Details

I. General information

NPI: 1588390249
Provider Name (Legal Business Name): LAURA C RAMOS PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3304 SALISBURY DR
HOLIDAY FL
34691-4739
US

IV. Provider business mailing address

3304 SALISBURY DR
HOLIDAY FL
34691-4739
US

V. Phone/Fax

Practice location:
  • Phone: 786-740-3180
  • Fax:
Mailing address:
  • Phone: 786-740-3180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB780624
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: