Healthcare Provider Details

I. General information

NPI: 1396301016
Provider Name (Legal Business Name): CAMILA ALBERTO MUNOZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2019
Last Update Date: 10/21/2026
Certification Date: 10/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18122 NW 91ST CT
HIALEAH FL
33018-6544
US

IV. Provider business mailing address

18122 NW 91ST CT
HIALEAH FL
33018-6544
US

V. Phone/Fax

Practice location:
  • Phone: 305-590-7674
  • Fax:
Mailing address:
  • Phone: 305-590-7674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH28815
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1262862407
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: