Provider Demographics
NPI:1235959677
Name:RAMOS ALFONSO, RYAN
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:RAMOS ALFONSO
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 1:15413 SW 288TH ST APT 215
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-5835
Mailing Address - Country:US
Mailing Address - Phone:786-786-4839
Mailing Address - Fax:
Practice Address - Street 1:15413 SW 288TH ST APT 215
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-5835
Practice Address - Country:US
Practice Address - Phone:786-786-4839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician