Healthcare Provider Details

I. General information

NPI: 1508708256
Provider Name (Legal Business Name): RAMSES DE JESUS REYES GONZALEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17525 SW 35TH AVENUE RD # 109
OCALA FL
34473-3730
US

IV. Provider business mailing address

17525 SW 35TH AVENUE RD
OCALA FL
34473-3730
US

V. Phone/Fax

Practice location:
  • Phone: 656-200-6797
  • Fax:
Mailing address:
  • Phone: 656-200-6797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17060
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: