Provider Demographics
NPI:1336032309
Name:JARAMILLO, EVA MARIE
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:MARIE
Last Name:JARAMILLO
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 1:20001 BARLETTA LN UNIT 2026
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-6399
Mailing Address - Country:US
Mailing Address - Phone:239-896-8193
Mailing Address - Fax:
Practice Address - Street 1:15335 SAM SNEAD LN
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33917-3263
Practice Address - Country:US
Practice Address - Phone:941-500-4048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPENDING106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician