Provider Demographics
NPI:1356113930
Name:RAMOS, ANDREA (PHD, RN, EMDR)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:
Credentials:PHD, RN, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19650 OAK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33967-6216
Mailing Address - Country:US
Mailing Address - Phone:239-313-8597
Mailing Address - Fax:
Practice Address - Street 1:3368 WOODS EDGE CIR STE 103
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-3437
Practice Address - Country:US
Practice Address - Phone:239-313-8597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY776791-01163W00000X, 163WP0808X
FLRN9412924163W00000X, 163WG0000X, 163WP0807X, 163WP0808X
171400000X, 175F00000X, 175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No171400000XOther Service ProvidersHealth & Wellness Coach
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath