Provider Demographics
NPI:1629555867
Name:RAMIREZ, GUANIN SR
Entity type:Individual
Prefix:
First Name:GUANIN
Middle Name:
Last Name:RAMIREZ
Suffix:SR
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 1:7721 NW 7TH ST APT 803
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-6110
Mailing Address - Country:US
Mailing Address - Phone:786-427-5464
Mailing Address - Fax:
Practice Address - Street 1:7721 NW 7TH ST APT 803
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-6110
Practice Address - Country:US
Practice Address - Phone:786-427-5464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL020407600106S00000X
FL1-20-42025103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020407600Medicaid