Provider Demographics
NPI:1689281479
Name:RAMOS, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
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 1:2212 GRAND CAYMAN CT APT 1634
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-2780
Mailing Address - Country:US
Mailing Address - Phone:773-991-4434
Mailing Address - Fax:
Practice Address - Street 1:6100 LAKE ELLENOR DR STE 151
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-4632
Practice Address - Country:US
Practice Address - Phone:407-552-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health