Provider Demographics
NPI:1629734470
Name:RAMIREZ, SIERRA ELYSSA (OT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:ELYSSA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 18TH CT
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962-1422
Mailing Address - Country:US
Mailing Address - Phone:772-538-0395
Mailing Address - Fax:
Practice Address - Street 1:1701 SE HILLMOOR DR
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-342-1435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22498225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist