Provider Demographics
NPI:1700249489
Name:VARGAS RAMOS, LUIS
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:VARGAS RAMOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8762 PISA DR APT 215
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-2119
Mailing Address - Country:US
Mailing Address - Phone:787-210-9694
Mailing Address - Fax:
Practice Address - Street 1:1320 N MAIN ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-4289
Practice Address - Country:US
Practice Address - Phone:407-343-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-31
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker