Provider Demographics
NPI:1215531751
Name:PRICE, CAMILLE YOLANDE (RPH)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:YOLANDE
Last Name:PRICE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5880 S GOLDEN BEAUTY LN
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-6361
Mailing Address - Country:US
Mailing Address - Phone:954-816-1391
Mailing Address - Fax:
Practice Address - Street 1:1900 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-2230
Practice Address - Country:US
Practice Address - Phone:954-436-5635
Practice Address - Fax:954-436-6837
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS34394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist