Provider Demographics
NPI:1033795307
Name:BEUNES RAMIREZ, ELENA CARIDAD
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:CARIDAD
Last Name:BEUNES RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:CARIDAD
Other - Last Name:BEUNES RAMIREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:19448 BOBOLINK DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2440
Mailing Address - Country:US
Mailing Address - Phone:954-937-6239
Mailing Address - Fax:
Practice Address - Street 1:19448 BOBOLINK DR
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33015-2440
Practice Address - Country:US
Practice Address - Phone:954-937-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-149794106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT149794OtherBACB