Healthcare Provider Details

I. General information

NPI: 1336355684
Provider Name (Legal Business Name): RAMON MAISONET M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAMON MAISONET GONZALEZ LMHC

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4024 CENTRAL AVE
ST PETE FL
33711-1239
US

IV. Provider business mailing address

7349 ULMERTON RD LOT 247
LARGO FL
33771-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-327-7656
  • Fax: 727-322-2130
Mailing address:
  • Phone: 787-607-6846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1789
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberMH21695
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number21695
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: