Provider Demographics
NPI:1215170642
Name:RAMOS, MARIA RODRIQUEZ (PT)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:RODRIQUEZ
Last Name:RAMOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22133 GRATIOT AVE
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-2260
Mailing Address - Country:US
Mailing Address - Phone:586-776-0080
Mailing Address - Fax:586-776-4349
Practice Address - Street 1:22133 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-2260
Practice Address - Country:US
Practice Address - Phone:586-776-0080
Practice Address - Fax:586-776-4349
Is Sole Proprietor?:No
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012693225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist