Healthcare Provider Details

I. General information

NPI: 1215045596
Provider Name (Legal Business Name): CAMILLE ZAMPINO BENTLEY D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S UNIVERSITY DR
DAVIE FL
33328-2018
US

IV. Provider business mailing address

7581 NW 28TH ST
MARGATE FL
33063-7883
US

V. Phone/Fax

Practice location:
  • Phone: 954-262-4100
  • Fax:
Mailing address:
  • Phone: 954-344-9492
  • Fax: 954-262-3753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS 0006645
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: