Provider Demographics
NPI:1093980237
Name:DE LEON, CAMILE CESAR (PT)
Entity Type:Individual
Prefix:
First Name:CAMILE
Middle Name:CESAR
Last Name:DE LEON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 OAK ST.
Mailing Address - Street 2:SUITE 105
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5834
Mailing Address - Country:US
Mailing Address - Phone:407-483-9540
Mailing Address - Fax:407-483-9541
Practice Address - Street 1:809 E OAK ST
Practice Address - Street 2:SUITE 105
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5834
Practice Address - Country:US
Practice Address - Phone:407-483-9540
Practice Address - Fax:407-483-9541
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT7516225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist