Healthcare Provider Details

I. General information

NPI: 1114923703
Provider Name (Legal Business Name): CAMILLE J DYER P.A.-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 08/21/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8440 LAKE WORTH RD STE 100
WELLINGTON FL
33467
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-967-5033
  • Fax:
Mailing address:
  • Phone: 561-966-7717
  • Fax: 888-316-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9110521
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: