Healthcare Provider Details

I. General information

NPI: 1972486140
Provider Name (Legal Business Name): CAMILLE C FLOYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOWELL MILL RD NW STE 200
ATLANTA GA
30318-0917
US

IV. Provider business mailing address

3100 INTERSTATE NORTH CIR SE STE 500
ATLANTA GA
30339-2296
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-1015
  • Fax: 404-477-1176
Mailing address:
  • Phone: 678-996-7230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT017862
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: