Provider Demographics
NPI:1710342407
Name:GOMEZ RAMOS, BERENICE (BS IN PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:BERENICE
Middle Name:
Last Name:GOMEZ RAMOS
Suffix:
Gender:F
Credentials:BS IN PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1263 NW 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-7176
Mailing Address - Country:US
Mailing Address - Phone:786-267-7027
Mailing Address - Fax:
Practice Address - Street 1:1263 NW 87TH AVE
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071-7176
Practice Address - Country:US
Practice Address - Phone:786-267-7027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-22
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-22-62706103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst