Provider Demographics
NPI:1851193940
Name:RAMIREZ VALIENTE, LISBE
Entity type:Individual
Prefix:
First Name:LISBE
Middle Name:
Last Name:RAMIREZ VALIENTE
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 1:1513 ORANGE AVE FL 34769
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4740
Mailing Address - Country:US
Mailing Address - Phone:786-413-2817
Mailing Address - Fax:
Practice Address - Street 1:1513 ORANGE AVE FL 34769
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34769-4740
Practice Address - Country:US
Practice Address - Phone:786-413-2817
Practice Address - Fax:786-413-2817
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL25411529106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician