Provider Demographics
NPI:1669021069
Name:RAMOS, KAYLEIGH
Entity Type:Individual
Prefix:
First Name:KAYLEIGH
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLEIGH
Other - Middle Name:
Other - Last Name:JAMMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:113 MAHOGANY BAY DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6949
Mailing Address - Country:US
Mailing Address - Phone:904-305-2069
Mailing Address - Fax:
Practice Address - Street 1:113 MAHOGANY BAY DR
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-6949
Practice Address - Country:US
Practice Address - Phone:904-305-2069
Practice Address - Fax:904-342-4130
Is Sole Proprietor?:No
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician