Provider Demographics
NPI:1467249284
Name:SEOANE AMARGO, CAMILO ERNESTO
Entity type:Individual
Prefix:
First Name:CAMILO
Middle Name:ERNESTO
Last Name:SEOANE AMARGO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 SW 137TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-3726
Mailing Address - Country:US
Mailing Address - Phone:786-599-8056
Mailing Address - Fax:
Practice Address - Street 1:4207 SW 137TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-3726
Practice Address - Country:US
Practice Address - Phone:786-599-8056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-426955106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician