Provider Demographics
NPI:1134425432
Name:CAMINO, DIDIER
Entity type:Individual
Prefix:MR
First Name:DIDIER
Middle Name:
Last Name:CAMINO
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 1:8300 NW 185TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-2645
Mailing Address - Country:US
Mailing Address - Phone:305-764-5789
Mailing Address - Fax:305-262-6678
Practice Address - Street 1:7821 CORAL WAY
Practice Address - Street 2:SUITE 132
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6542
Practice Address - Country:US
Practice Address - Phone:305-764-5789
Practice Address - Fax:305-262-6678
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPTA19894225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant