Provider Demographics
NPI:1437926672
Name:GOMEZ, CAMILLE (RMHCI)
Entity Type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10010 BAHAMA DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1504
Mailing Address - Country:US
Mailing Address - Phone:305-458-7962
Mailing Address - Fax:
Practice Address - Street 1:1550 MADRUGA AVE STE 509
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3048
Practice Address - Country:US
Practice Address - Phone:786-536-9714
Practice Address - Fax:786-536-9833
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH25091101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health