Provider Demographics
NPI:1003032301
Name:RAMIREZ, MARIBEL (COT)
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:COT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 DIAMOND HEAD DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331
Mailing Address - Country:US
Mailing Address - Phone:954-732-4875
Mailing Address - Fax:954-384-4892
Practice Address - Street 1:10773 NW 58TH ST
Practice Address - Street 2:#130
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178
Practice Address - Country:US
Practice Address - Phone:954-732-4875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
70392156F00000X, 156FX1100X, 156FX1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered156F00000XEye and Vision Services ProvidersTechnician/Technologist
Not Answered156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Not Answered156FX1101XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic Assistant