Provider Demographics
NPI:1568932150
Name:GUARINO CAMGEMI, VICENTE JOSE (SA-C)
Entity Type:Individual
Prefix:
First Name:VICENTE
Middle Name:JOSE
Last Name:GUARINO CAMGEMI
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12921 ENTRADA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-4617
Mailing Address - Country:US
Mailing Address - Phone:407-437-4858
Mailing Address - Fax:
Practice Address - Street 1:12921 ENTRADA DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-4617
Practice Address - Country:US
Practice Address - Phone:407-437-4858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18-493246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant