Provider Demographics
NPI:1467761577
Name:RAMOS, MODESTO (IMH)
Entity Type:Individual
Prefix:
First Name:MODESTO
Middle Name:
Last Name:RAMOS
Suffix:
Gender:M
Credentials:IMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10671 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1510
Mailing Address - Country:US
Mailing Address - Phone:305-416-0811
Mailing Address - Fax:
Practice Address - Street 1:701 SW 27TH AVE
Practice Address - Street 2:SUITE G20
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33135-3031
Practice Address - Country:US
Practice Address - Phone:305-643-7800
Practice Address - Fax:305-643-1345
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health