Provider Demographics
NPI:1730562430
Name:RAMIREZ, LUCIA KARINA (COTA)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:KARINA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6780 SW 44TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-4732
Mailing Address - Country:US
Mailing Address - Phone:786-359-7356
Mailing Address - Fax:
Practice Address - Street 1:47 NW 32ND PL
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-4914
Practice Address - Country:US
Practice Address - Phone:305-649-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA11201320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities