MEDICARE: CHRISTIAN D CAMERON BCBA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	222Q00000X	Developmental Therapist
2	103K00000X	Behavior Analyst	1-25-85704	FL

General Provider Information

NPI Number	:	1700374238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN D CAMERON BCBA

Provider Business Mailing Address
First Line	:	619 NW 89TH AVE
Second Line	:
City	:	PLANTATION
State	:	FL
Zip	:	33324-6105
Country	:	US
Telephone Number	:	716-228-3066
Fax Number	:

Provider Business Practice Location Address
First Line	:	3341 N UNIVERSITY DR
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33024-2230
Country	:	US
Telephone Number	:	716-228-3066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2018
Last Update Date	:	11/12/2025

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