MEDICARE: MARYSOL 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	106S00000X	Behavior Technician	RBT-17-45185	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619477858
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYSOL RAMOS

Provider Business Mailing Address
First Line	:	2252 10TH TER
Second Line	:
City	:	LEHIGH ACRES
State	:	FL
Zip	:	33936-3258
Country	:	US
Telephone Number	:	239-322-8838
Fax Number	:

Provider Business Practice Location Address
First Line	:	6844 INTERNATIONAL CENTER BLVD STE 500
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7159
Country	:	US
Telephone Number	:	417-860-7640
Fax Number	:

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

Provider Enumeration Date	:	02/14/2018
Last Update Date	:	02/14/2018

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Directions to “ MARYSOL RAMOS ” Practice Location

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