Provider Demographics
NPI:1497320345
Name:CAMACHO ACEVEDO, ZULIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:ZULIE
Middle Name:ANN
Last Name:CAMACHO ACEVEDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4799A GUADALCANAL ST
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-1960
Mailing Address - Country:US
Mailing Address - Phone:407-504-0511
Mailing Address - Fax:
Practice Address - Street 1:1101 MIRANDA LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-0769
Practice Address - Country:US
Practice Address - Phone:407-494-3787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11671103TC0700X
FLPY11671103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical