Provider Demographics
NPI:1720294630
Name:CAMMAROTA, ADELA CARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:ADELA
Middle Name:CARMEN
Last Name:CAMMAROTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10075 COSTA DEL SOL BLVD
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-2370
Mailing Address - Country:US
Mailing Address - Phone:305-477-6644
Mailing Address - Fax:
Practice Address - Street 1:2355 SALZEDO ST STE 305
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5061
Practice Address - Country:US
Practice Address - Phone:305-448-4818
Practice Address - Fax:305-448-0244
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 633542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry