Provider Demographics
NPI:1528309416
Name:FLUELLEN, RA'MONE MARQUIS
Entity type:Individual
Prefix:MR
First Name:RA'MONE
Middle Name:MARQUIS
Last Name:FLUELLEN
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 1:190 NE 199TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-2927
Mailing Address - Country:US
Mailing Address - Phone:786-269-2388
Mailing Address - Fax:866-615-0413
Practice Address - Street 1:190 NE 199TH ST STE 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33179-2927
Practice Address - Country:US
Practice Address - Phone:786-269-2388
Practice Address - Fax:866-615-0413
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-03
Last Update Date:2013-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3192104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker