Provider Demographics
NPI:1548766942
Name:AYALA RAMIREZ, ERICK
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:
Last Name:AYALA RAMIREZ
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 1:14180 SW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:KENDALL
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4080
Mailing Address - Country:US
Mailing Address - Phone:786-482-0727
Mailing Address - Fax:305-742-2190
Practice Address - Street 1:14180 SW 84TH ST # G206
Practice Address - Street 2:
Practice Address - City:KENDALL
Practice Address - State:FL
Practice Address - Zip Code:33183-4080
Practice Address - Country:US
Practice Address - Phone:786-482-0727
Practice Address - Fax:305-742-2190
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FLRBT-18-74151106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician