Provider Demographics
NPI:1760245666
Name:RAMIREZ, KAYLYNA M
Entity Type:Individual
Prefix:
First Name:KAYLYNA
Middle Name:M
Last Name:RAMIREZ
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 1:402 NW KILPATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-1603
Mailing Address - Country:US
Mailing Address - Phone:177-277-7676
Mailing Address - Fax:772-264-7626
Practice Address - Street 1:402 NW KILPATRICK AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983-1603
Practice Address - Country:US
Practice Address - Phone:772-777-6761
Practice Address - Fax:772-264-7626
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy