Healthcare Provider Details

I. General information

NPI: 1124949763
Provider Name (Legal Business Name): CARLOS ANDRES VALENTIN CAMUNAS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 NW 14TH ST
MIAMI FL
33136-2107
US

IV. Provider business mailing address

50 BISCAYNE BLVD APT 1509
MIAMI FL
33132-2930
US

V. Phone/Fax

Practice location:
  • Phone: 787-439-6544
  • Fax:
Mailing address:
  • Phone: 787-439-6544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY13080
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: