Healthcare Provider Details

I. General information

NPI: 1003481557
Provider Name (Legal Business Name): CAMILA ANDREA GAMEZ YOUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5425 GOLDEN GATE PKWY STE 7
NAPLES FL
34116-7524
US

IV. Provider business mailing address

8478 BUTTERNUT RD
FORT MYERS FL
33967-3462
US

V. Phone/Fax

Practice location:
  • Phone: 239-778-8455
  • Fax:
Mailing address:
  • Phone: 646-660-5924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: