Provider Demographics
NPI:1982330064
Name:RAMOS-DEVINE, TYLISHA
Entity Type:Individual
Prefix:
First Name:TYLISHA
Middle Name:
Last Name:RAMOS-DEVINE
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 1:6927 VILLA DE COSTA DR APT 204
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32821-8404
Mailing Address - Country:US
Mailing Address - Phone:610-355-5469
Mailing Address - Fax:
Practice Address - Street 1:6927 VILLA DE COSTA DR APT 204
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32821-8404
Practice Address - Country:US
Practice Address - Phone:610-355-5469
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator