Healthcare Provider Details

I. General information

NPI: 1578489522
Provider Name (Legal Business Name): ANTONIO DAVID RAMIREZ-DOSSANTOS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8040 IANS ALY
LAUREL MD
20724-6133
US

IV. Provider business mailing address

14059 VISTA DR
LAUREL MD
20707-6828
US

V. Phone/Fax

Practice location:
  • Phone: 202-277-5801
  • Fax:
Mailing address:
  • Phone:
  • 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: