Provider Demographics
NPI:1104408673
Name:RAMOS-SABILLON, BETHANIA AURORA (SA- C)
Entity type:Individual
Prefix:
First Name:BETHANIA
Middle Name:AURORA
Last Name:RAMOS-SABILLON
Suffix:
Gender:F
Credentials:SA- C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4726 NW 50TH CT
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-3660
Mailing Address - Country:US
Mailing Address - Phone:305-607-0326
Mailing Address - Fax:
Practice Address - Street 1:4726 NW 50TH CT
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33319-3660
Practice Address - Country:US
Practice Address - Phone:305-607-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14-177246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant