Provider Demographics
NPI:1093387441
Name:RAMIREZ, DEYSI (RBT)
Entity Type:Individual
Prefix:
First Name:DEYSI
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2641 NE 4TH ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-7065
Mailing Address - Country:US
Mailing Address - Phone:786-662-9654
Mailing Address - Fax:
Practice Address - Street 1:950 N KROME AVE STE 409
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4443
Practice Address - Country:US
Practice Address - Phone:786-351-6878
Practice Address - Fax:786-504-8924
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-18-70478106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR562160605110Medicaid