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General NPI Number Information
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NPI Number | 1356764369
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Entity Type | Individual
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Provider Name | CAMILLA MINUS
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 5112 LA SALLE ST APT A
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City | FORT PIERCE
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State | FL
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Zip | 34951-5035
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Country | US
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Telephone | 772-205-7028
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 651521
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City | VERO BEACH
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State | FL
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Zip | 32965-1521
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Country | US
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Telephone | 772-205-7028
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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 | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number | CNA124830
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA124830
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number | RN9178180
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License Number State | FL
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