Healthcare Provider Details

I. General information

NPI: 1306462916
Provider Name (Legal Business Name): ERICA JENINE RAMOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2020
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 COMMERCE CENTER DR
SAINT CLOUD FL
34769-1549
US

IV. Provider business mailing address

12114 MAGAZINE ST APT 3110
ORLANDO FL
32828-5535
US

V. Phone/Fax

Practice location:
  • Phone: 407-989-4040
  • Fax: 407-989-4040
Mailing address:
  • Phone: 407-271-7940
  • Fax: 407-989-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-23-14919
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: