MEDICARE: ETHEL RAMIREZ VELAZQUEZ PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1558134320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHEL RAMIREZ VELAZQUEZ PHD

Provider Business Mailing Address
First Line	:	11780 SW 190TH TERRACE RD
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33177-3951
Country	:	US
Telephone Number	:	305-986-7508
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 E 9TH ST
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4650
Country	:	US
Telephone Number	:	305-381-5294
Fax Number	:	786-685-2266

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2023
Last Update Date	:	11/03/2023

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