Provider Demographics
NPI:1033711601
Name:RAMIREZ, MICHELLE (MSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:GAMELIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:126 LITHIA PINECREST RD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5347
Mailing Address - Country:US
Mailing Address - Phone:813-689-8828
Mailing Address - Fax:
Practice Address - Street 1:126 LITHIA PINECREST RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5347
Practice Address - Country:US
Practice Address - Phone:813-689-8828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical