Basic Information
| Provider Information | |||||||||
| NPI: | 1619427465 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMIREZ-SCHWARZ | ||||||||
| FirstName: | TANJA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1855 W HIBISCUS BLVD | ||||||||
| Address2: | |||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329012622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212644409 | ||||||||
| FaxNumber: | 3217656434 | ||||||||
| Practice Location | |||||||||
| Address1: | 1855 W HIBISCUS BLVD | ||||||||
| Address2: | |||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329012622 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3212644409 | ||||||||
| FaxNumber: | 3217656434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2016 | ||||||||
| LastUpdateDate: | 03/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | RBT-16-22886 | FL | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 103K00000X | 1-17-28454 | FL | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.