Provider Demographics
NPI:1114724697
Name:PERALTA DE JESUS, RAMONA MERCEDES
Entity type:Individual
Prefix:
First Name:RAMONA
Middle Name:MERCEDES
Last Name:PERALTA DE JESUS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5325 CURRY FORD RD APT F101
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8810
Mailing Address - Country:US
Mailing Address - Phone:407-732-1092
Mailing Address - Fax:
Practice Address - Street 1:1527 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2116
Practice Address - Country:US
Practice Address - Phone:407-982-7718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst