Healthcare Provider Details

I. General information

NPI: 1982184016
Provider Name (Legal Business Name): YAMIREYDI SUAREZ RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 MC DERMOTT LN
ROYAL PALM BEACH FL
33411-4016
US

IV. Provider business mailing address

1370 MC DERMOTT LN
ROYAL PALM BEACH FL
33411-4016
US

V. Phone/Fax

Practice location:
  • Phone: 786-623-9456
  • Fax:
Mailing address:
  • Phone: 786-623-9456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-20-11311
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-59519
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-21-54912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: