Provider Demographics
NPI:1952651796
Name:MAURICIO RAMIREZ LCSW PA
Entity Type:Organization
Organization Name:MAURICIO RAMIREZ LCSW PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:239-289-3890
Mailing Address - Street 1:2180 IMMOKALEE RD
Mailing Address - Street 2:SUITE 216
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1421
Mailing Address - Country:US
Mailing Address - Phone:239-289-3890
Mailing Address - Fax:239-596-8901
Practice Address - Street 1:2180 IMMOKALEE RD
Practice Address - Street 2:SUITE 216
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1421
Practice Address - Country:US
Practice Address - Phone:239-289-3890
Practice Address - Fax:239-596-8901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 46591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
Z8840Medicare PIN