Provider Demographics
NPI:1982365870
Name:RAMIREZ, SUSANA MARIA (RBT)
Entity type:Individual
Prefix:
First Name:SUSANA
Middle Name:MARIA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:SUSANA
Other - Middle Name:MARIA
Other - Last Name:RAMIREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:4303 SW 120TH WAY APT 107
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7708
Mailing Address - Country:US
Mailing Address - Phone:786-282-6234
Mailing Address - Fax:
Practice Address - Street 1:4303 SW 120TH WAY APT 107
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7708
Practice Address - Country:US
Practice Address - Phone:786-282-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-19-77147106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician