Healthcare Provider Details

I. General information

NPI: 1861469710
Provider Name (Legal Business Name): RAMIREZ THERAPY SERVICES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 12/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N MACARTHUR AVE SUITE A
PANAMA CITY FL
32401-3636
US

IV. Provider business mailing address

502 N MACARTHUR AVE SUITE A
PANAMA CITY FL
32401-3636
US

V. Phone/Fax

Practice location:
  • Phone: 850-769-9008
  • Fax: 850-769-9024
Mailing address:
  • Phone: 850-769-9008
  • Fax: 850-769-9024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA 8094
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 11516
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 19638
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 2840
License Number StateFL

VIII. Authorized Official

Name: MRS. SALLIE NELSON
Title or Position: BUSINESS MANAGER
Credential:
Phone: 850-769-9008