Provider Demographics
NPI:1578841755
Name:RAMOS, ELISA MARABELLA
Entity Type:Individual
Prefix:
First Name:ELISA
Middle Name:MARABELLA
Last Name:RAMOS
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 1:4760 OLIVE BRANCH RD
Mailing Address - Street 2:APT 1612
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32811-7398
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4760 OLIVE BRANCH RD
Practice Address - Street 2:APT 1612
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32811-7398
Practice Address - Country:US
Practice Address - Phone:407-770-8255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor