Provider Demographics
NPI:1629312129
Name:CAMINO, KATHERINE GUNDERMAN (MS, SLP)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:GUNDERMAN
Last Name:CAMINO
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8012 SW 133RD PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33183-4133
Mailing Address - Country:US
Mailing Address - Phone:305-298-4246
Mailing Address - Fax:
Practice Address - Street 1:18951 SW 106TH AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-7668
Practice Address - Country:US
Practice Address - Phone:305-233-4448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-21
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ5886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist