Provider Demographics
NPI:1942849997
Name:OSTINVIL, CAMY FRED
Entity Type:Individual
Prefix:
First Name:CAMY
Middle Name:FRED
Last Name:OSTINVIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:826 SW 8TH CT
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-2425
Mailing Address - Country:US
Mailing Address - Phone:239-699-9232
Mailing Address - Fax:
Practice Address - Street 1:3049 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-7041
Practice Address - Country:US
Practice Address - Phone:239-689-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-21
Last Update Date:2019-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health