Healthcare Provider Details

I. General information

NPI: 1144769019
Provider Name (Legal Business Name): CAMILLE KRAMER MS CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 05/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 17TH AVE
VERO BEACH FL
32960
US

IV. Provider business mailing address

1705 17TH AVE
VERO BEACH FL
32960-3641
US

V. Phone/Fax

Practice location:
  • Phone: 772-559-0959
  • Fax:
Mailing address:
  • Phone: 772-562-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14067253
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: