Provider Demographics
NPI:1124980958
Name:JEREZANO, RAMON
Entity type:Individual
Prefix:
First Name:RAMON
Middle Name:
Last Name:JEREZANO
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 1:1840 NE 186TH ST APT 2E
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4363
Mailing Address - Country:US
Mailing Address - Phone:786-975-7001
Mailing Address - Fax:
Practice Address - Street 1:1840 NE 186TH ST APT 2E
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4363
Practice Address - Country:US
Practice Address - Phone:786-294-4962
Practice Address - Fax:786-294-4962
Is Sole Proprietor?:No
Enumeration Date:2025-12-01
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst