Provider Demographics
NPI:1083950372
Name:MYERS, CAMILLE (RRT)
Entity type:Individual
Prefix:
First Name:CAMILLE
Middle Name:
Last Name:MYERS
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10302 S FEDERAL HWY # 330
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-5605
Mailing Address - Country:US
Mailing Address - Phone:936-446-0292
Mailing Address - Fax:772-288-6475
Practice Address - Street 1:10302 S FEDERAL HWY # 330
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5605
Practice Address - Country:US
Practice Address - Phone:936-446-0292
Practice Address - Fax:772-288-6475
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12468227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered