Provider Demographics
NPI:1114760576
Name:RAMKELLAWAN, BIBI ISHA SARAH
Entity type:Individual
Prefix:
First Name:BIBI
Middle Name:ISHA SARAH
Last Name:RAMKELLAWAN
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 1:22053 SW 95TH PL
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33190-1244
Mailing Address - Country:US
Mailing Address - Phone:786-252-0450
Mailing Address - Fax:
Practice Address - Street 1:22053 SW 95TH PL
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33190-1244
Practice Address - Country:US
Practice Address - Phone:786-252-0450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-354159106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician