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General NPI Number Information
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NPI Number | 1215414701
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Entity Type | Individual
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Provider Name | ELIZEU SABINO CAMARGO
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Gender | Male
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 1203 FLORIDA AVE
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City | SAINT CLOUD
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State | FL
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Zip | 34769-3721
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Country | US
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Telephone | 407-593-2757
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Fax |
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Provider Business Mailing Address
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Address Line | 2017 BRIDGEVIEW CIR
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City | ORLANDO
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State | FL
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Zip | 32824-5620
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Country | US
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Telephone | 407-879-7728
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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