MEDICARE: SAMANTHA ARACELY RAMOS

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	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1568124196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA ARACELY RAMOS

Provider Business Mailing Address
First Line	:	12424 SW 125TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5538
Country	:	US
Telephone Number	:	786-999-9146
Fax Number	:

Provider Business Practice Location Address
First Line	:	12424 SW 125TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33186-5538
Country	:	US
Telephone Number	:	786-999-9146
Fax Number	:

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

Provider Enumeration Date	:	10/11/2021
Last Update Date	:	10/11/2021

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Directions to “ SAMANTHA ARACELY RAMOS ” Practice Location

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