Provider Demographics
NPI:1912554536
Name:DIAZ DE RAMIREZ, MARIA ANGELICA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANGELICA
Last Name:DIAZ DE 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 1:14255 SW 57TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-1077
Mailing Address - Country:US
Mailing Address - Phone:786-683-6665
Mailing Address - Fax:
Practice Address - Street 1:14255 SW 57TH LN
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1077
Practice Address - Country:US
Practice Address - Phone:786-683-6665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-19
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0-21-12794106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst