Provider Demographics
NPI:1891311809
Name:RAMIREZ SANTIESTEBAN, STEFANY (RBT)
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:
Last Name:RAMIREZ SANTIESTEBAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5435 SW 102ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7149
Mailing Address - Country:US
Mailing Address - Phone:305-582-3779
Mailing Address - Fax:
Practice Address - Street 1:5435 SW 102ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7149
Practice Address - Country:US
Practice Address - Phone:305-582-3779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-20-123300106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty