Healthcare Provider Details

I. General information

NPI: 1689558231
Provider Name (Legal Business Name): DIANA ROSA RAMIREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3175 S CONGRESS AVE STE 103
PALM SPRINGS FL
33461-2502
US

IV. Provider business mailing address

505 ASPEN RD
WEST PALM BEACH FL
33409-6201
US

V. Phone/Fax

Practice location:
  • Phone: 561-729-6631
  • Fax:
Mailing address:
  • Phone: 515-200-8726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number1232153
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: