Provider Demographics
NPI:1841672417
Name:ALBUQUERQUE PAIVA, CAMILA
Entity type:Individual
Prefix:
First Name:CAMILA
Middle Name:
Last Name:ALBUQUERQUE PAIVA
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 1:5805 BLUE LAGOON DR STE 440
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2032
Mailing Address - Country:US
Mailing Address - Phone:561-476-3406
Mailing Address - Fax:
Practice Address - Street 1:5805 BLUE LAGOON DR STE 440
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-2032
Practice Address - Country:US
Practice Address - Phone:561-476-3406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1442472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty