Provider Demographics
NPI:1154131621
Name:PRADO MOLINA, CAMILA DE JESUS
Entity type:Individual
Prefix:MS
First Name:CAMILA
Middle Name:DE JESUS
Last Name:PRADO MOLINA
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 1:2575 SANDS DR APT 303
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33764-3339
Mailing Address - Country:US
Mailing Address - Phone:786-246-0351
Mailing Address - Fax:
Practice Address - Street 1:2575 SANDS DR APT 303
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33764-3339
Practice Address - Country:US
Practice Address - Phone:786-246-0351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-326118106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician