Provider Demographics
NPI:1982035804
Name:CAMINO REYES, VANESSA (MD)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:CAMINO REYES
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 1:1530 CELEBRATION BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5164
Mailing Address - Country:US
Mailing Address - Phone:407-566-9700
Mailing Address - Fax:407-674-2254
Practice Address - Street 1:1530 CELEBRATION BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5164
Practice Address - Country:US
Practice Address - Phone:407-566-9700
Practice Address - Fax:407-674-2254
Is Sole Proprietor?:No
Enumeration Date:2013-12-03
Last Update Date:2016-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME127772208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics