Healthcare Provider Details

I. General information

NPI: 1083248751
Provider Name (Legal Business Name): NIURKA RAMIREZ TAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2020
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 SW DAY ST
PORT ST LUCIE FL
34953-1139
US

IV. Provider business mailing address

1809 SW DAY ST
PORT ST LUCIE FL
34953-1139
US

V. Phone/Fax

Practice location:
  • Phone: 754-204-0053
  • Fax:
Mailing address:
  • Phone: 754-204-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: