Provider Demographics
NPI:1497593636
Name:RAMOS DIAZ, DENISE M
Entity type:Individual
Prefix:
First Name:DENISE M
Middle Name:
Last Name:RAMOS DIAZ
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 1:3537 DAVIS LANDINGS CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33461-5540
Mailing Address - Country:US
Mailing Address - Phone:561-329-9681
Mailing Address - Fax:
Practice Address - Street 1:3537 DAVIS LANDINGS CIR
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33461-5540
Practice Address - Country:US
Practice Address - Phone:561-329-9681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician