Provider Demographics
NPI:1265510325
Name:CORTES RAMIREZ, LUZ V
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:V
Last Name:CORTES RAMIREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3024
Mailing Address - Country:US
Mailing Address - Phone:727-847-0069
Mailing Address - Fax:727-849-3780
Practice Address - Street 1:7702 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3024
Practice Address - Country:US
Practice Address - Phone:727-847-0069
Practice Address - Fax:727-849-3780
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01006104100000X
MA107850104100000X
FLSW7774104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1306715Medicaid
FL010751800Medicaid
MA1306715Medicaid