Provider Demographics
NPI:1053930560
Name:RAMOS, CATIA
Entity type:Individual
Prefix:
First Name:CATIA
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 FLORIDA MEMORIAL PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:NEW SMYRNA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32168-9311
Mailing Address - Country:US
Mailing Address - Phone:386-409-6811
Mailing Address - Fax:386-409-6903
Practice Address - Street 1:125 FLORIDA MEMORIAL PKWY STE 102
Practice Address - Street 2:
Practice Address - City:NEW SMYRNA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32168-9311
Practice Address - Country:US
Practice Address - Phone:386-409-6811
Practice Address - Fax:386-409-6903
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT0010640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist