Provider Demographics
NPI:1497521405
Name:RAMOS GARCIA, RAY CHARLES
Entity Type:Individual
Prefix:
First Name:RAY
Middle Name:CHARLES
Last Name:RAMOS GARCIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7355 COLDSTREAM DR
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2203
Mailing Address - Country:US
Mailing Address - Phone:305-834-0762
Mailing Address - Fax:
Practice Address - Street 1:7855 NE 2ND AVE APT 501
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-4979
Practice Address - Country:US
Practice Address - Phone:305-834-0762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-30
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
FL23-313950106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician