Healthcare Provider Details

I. General information

NPI: 1265421994
Provider Name (Legal Business Name): CAMILLE ANN CALDWELL ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2005
Last Update Date: 07/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13311 N 56TH ST
TAMPA FL
33617-1161
US

IV. Provider business mailing address

38135 MARKET SQ
ZEPHYRHILLS FL
33542-7505
US

V. Phone/Fax

Practice location:
  • Phone: 813-899-2015
  • Fax:
Mailing address:
  • Phone: 813-528-4975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 2011952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: