Provider Demographics
NPI:1598132060
Name:SANDERS, CAMILLE. A
Entity Type:Individual
Prefix:
First Name:CAMILLE. A
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5380 PEPPER BRUSH CV
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32703-1971
Mailing Address - Country:US
Mailing Address - Phone:407-637-1552
Mailing Address - Fax:
Practice Address - Street 1:5380 PEPPER BRUSH CV
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32703-1971
Practice Address - Country:US
Practice Address - Phone:407-637-1552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator