Provider Demographics
NPI:1396223384
Name:BURGOS-TORRES, CAMILE
Entity type:Individual
Prefix:
First Name:CAMILE
Middle Name:
Last Name:BURGOS-TORRES
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 1:233 E WILBUR AVE UNIT 237
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-3250
Mailing Address - Country:US
Mailing Address - Phone:787-428-6904
Mailing Address - Fax:
Practice Address - Street 1:415 S CHICKASAW TRL
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-7803
Practice Address - Country:US
Practice Address - Phone:787-264-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS5285237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist